<SEC-DOCUMENT>0001193125-18-236651.txt : 20180802
<SEC-HEADER>0001193125-18-236651.hdr.sgml : 20180802
<ACCEPTANCE-DATETIME>20180802163055
ACCESSION NUMBER:		0001193125-18-236651
CONFORMED SUBMISSION TYPE:	10-Q
PUBLIC DOCUMENT COUNT:		49
CONFORMED PERIOD OF REPORT:	20180630
FILED AS OF DATE:		20180802
DATE AS OF CHANGE:		20180802

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-Q
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-12111
		FILM NUMBER:		18988804

	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-Q
<SEQUENCE>1
<FILENAME>d558671d10q.htm
<DESCRIPTION>FORM 10-Q
<TEXT>
<HTML><HEAD>
<TITLE>Form 10-Q</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">
<h5 align="left"><a href="#toc">Table of Contents</a></h5>


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="line-height:1.0pt;margin-top:0pt;margin-bottom:0pt;border-bottom:1px solid #000000">&nbsp;</P>
<P STYLE="line-height:3.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1px solid #000000">&nbsp;</P> <P STYLE="margin-top:4pt; margin-bottom:0pt; font-size:18pt; font-family:Times New Roman" ALIGN="center"><B>UNITED STATES </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:18pt; font-family:Times New Roman" ALIGN="center"><B>SECURITIES AND EXCHANGE COMMISSION </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:12pt; font-family:Times New Roman" ALIGN="center"><B>Washington, D.C. 20549 </B></P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><center>
<P STYLE="line-height:6.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1.00pt solid #000000;width:21%">&nbsp;</P></center> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:18pt; font-family:Times New Roman" ALIGN="center"><B>FORM <FONT
STYLE="white-space:nowrap">10-Q</FONT> </B></P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><center>
<P STYLE="line-height:6.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1.00pt solid #000000;width:21%">&nbsp;</P></center> <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:12pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><B></B>&#9746;<B></B><B></B></TD>
<TD ALIGN="left" VALIGN="top"><B>QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 </B></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>For the quarterly period ended June&nbsp;30, 2018 </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>OR </B></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:12pt" BORDER="0" CELLPADDING="0" CELLSPACING="0" WIDTH="100%">
<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><B></B>&#9744;<B></B><B></B></TD>
<TD ALIGN="left" VALIGN="top"><B>TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 </B></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>For the transition period from
<U>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</U> to
<U>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</U> </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Commission File Number: <FONT STYLE="white-space:nowrap">001-12111</FONT> </B></P>
<P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><center> <P STYLE="line-height:6.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1.00pt solid #000000;width:21%">&nbsp;</P></center>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:24pt; 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>(Exact name
of registrant as specified in its charter) </B></P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><center>
<P STYLE="line-height:6.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1.00pt solid #000000;width:21%">&nbsp;</P></center> <P STYLE="font-size:6pt;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:8pt" ALIGN="center">


<TR>
<TD WIDTH="50%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="48%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" ALIGN="center"><B>Florida</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"><B><FONT STYLE="white-space:nowrap">26-3667538</FONT></B></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="top" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>(State or other jurisdiction of</B></P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>Incorporation or organization)</B></P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>(I.R.S. Employer</B></P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>Identification No.)</B></P></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" ALIGN="center"> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>1301 Concord Terrace</B></P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Sunrise, Florida</B></P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center"><B>33323</B></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
<TD VALIGN="top" ALIGN="center"><B>(Address of principal executive offices)</B></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top" ALIGN="center"><B>(Zip Code)</B></TD></TR>
</TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(954) <FONT STYLE="white-space:nowrap">384-0175</FONT> </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>(Registrant&#146;s telephone number, including area code) </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Not Applicable </B></P> <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>(Former
name, former address and former fiscal year, if changed since last report) </B></P> <P STYLE="font-size:6pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P><center>
<P STYLE="line-height:6.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1.00pt solid #000000;width:21%">&nbsp;</P></center> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, 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; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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, 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. </P>
<P STYLE="font-size:6pt;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="16%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="60%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="20%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="1%"></TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom">Large&nbsp;accelerated&nbsp;filer</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&#9746;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">Accelerated&nbsp;filer</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&#9744;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></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 ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"><FONT STYLE="white-space:nowrap">Non-accelerated&nbsp;filer</FONT></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&#9744;&nbsp;&nbsp;(Do not check if a smaller reporting company)</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">Smaller&nbsp;reporting&nbsp;company</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&#9744;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></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 ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">Emerging&nbsp;growth&nbsp;company</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&#9744;</TD></TR>
</TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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; </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Indicate by check mark whether the registrant is a shell company (as defined in 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; </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">On July&nbsp;27, 2018, the
registrant had outstanding 93,466,848 shares of Common Stock, par value $.01 per share. </P> <P STYLE="font-size:10pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<P STYLE="line-height:1.0pt;margin-top:0pt;margin-bottom:0pt;border-bottom:1px solid #000000">&nbsp;</P> <P STYLE="line-height:3.0pt;margin-top:0pt;margin-bottom:2pt;border-bottom:1px solid #000000">&nbsp;</P>
</DIV></Center>


<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>


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="toc"></A>MEDNAX, INC. </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>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="7%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="90%"></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:8pt">
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</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>Page</B></TD>
<TD VALIGN="bottom">&nbsp;</TD></TR>


<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" COLSPAN="3"><B><A HREF="#tx558671_1">PART I - FINANCIAL INFORMATION </A></B></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="2"></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">Item 1.</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx558671_2">Financial Statements </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="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"><A HREF="#tx558671_3">Condensed Consolidated Balance Sheets as of June&nbsp;30, 2018 and December&nbsp;31, 2017 (Unaudited)</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">3</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"><A HREF="#tx558671_4">Condensed Consolidated Statements of Income for the Three and Six Months Ended June&nbsp;30, 2018 and 2017 (Unaudited)</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">4</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"><A HREF="#tx558671_5">Condensed Consolidated Statements of Cash Flows for the Six Months Ended June&nbsp;30, 2018 and 2017 (Unaudited)</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">5</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"><A HREF="#tx558671_6">Notes to Condensed Consolidated Financial Statements (Unaudited)</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">6</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></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">Item 2.</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx558671_7">Management&#146;s Discussion and Analysis of Financial Condition and Results of Operations</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">12</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></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">Item 3.</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx558671_8">Quantitative and Qualitative Disclosures About Market Risk</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></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">Item 4.</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx558671_9">Controls and Procedures</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8" COLSPAN="3"></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" COLSPAN="3"><B><A HREF="#tx558671_10">PART II - OTHER INFORMATION </A></B></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="2"></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">Item 1.</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx558671_11">Legal Proceedings</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">21</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></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">Item 1A.</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx558671_12">Risk Factors</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">21</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></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">Item 2.</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx558671_13">Unregistered Sales of Equity Securities and Use of Proceeds</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">21</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></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">Item 5.</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx558671_14">Other Information</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8"></TD>
<TD HEIGHT="8" COLSPAN="2"></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">Item 6.</P></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom"><A HREF="#tx558671_15">Exhibits</A></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">23</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="8" COLSPAN="3"></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" COLSPAN="3"><B><A HREF="#tx558671_16">SIGNATURES </A></B></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">24</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">2 </P>

</DIV></Center>


<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>


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx558671_1"></A>PART I - FINANCIAL INFORMATION </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="8%" VALIGN="top" ALIGN="left"><B><A NAME="tx558671_2"></A>Item&nbsp;1.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Financial Statements </B></P></TD></TR></TABLE>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx558671_3"></A>MEDNAX, INC. </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>CONDENSED 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="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(Unaudited) </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="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="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>June&nbsp;30,&nbsp;2018</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>December&nbsp;31,&nbsp;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" 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">$</TD>
<TD VALIGN="bottom" ALIGN="right">38,056</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">60,200</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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">Restricted cash</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">19,000</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;&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">Short-term investments</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">9,902</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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 receivable, net</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">527,997</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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">Prepaid expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">15,752</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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">Other current assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">14,223</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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 assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">624,930</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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">Restricted cash</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">20,000</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">Investments</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">90,186</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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">Property and equipment, net</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">131,922</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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">Goodwill</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,304,740</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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">Intangible assets, net</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">614,226</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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 assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,634</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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 assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">5,859,638</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">5,867,278</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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 BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top" ALIGN="center"><B>LIABILITIES AND 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 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 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 payable and accrued expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">358,255</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">438,017</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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 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">860</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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 taxes payable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">52,098</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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 liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">411,213</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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">Line of credit</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,149,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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 debt and capital lease obligations, net</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">741,612</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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 professional liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">207,687</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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">Deferred income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">126,505</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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 liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">36,199</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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:7.00em; 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">2,672,716</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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: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 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 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">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 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; $.01 par value; 200,000 shares authorized; 93,374 and 93,721 shares issued and
outstanding, respectively</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">934</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 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">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">1,032,573</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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">Retained earnings</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,153,415</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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:7.00em; 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">3,186,922</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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:9.00em; 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">5,859,638</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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; font-size:10pt; font-family:Times New Roman" ALIGN="center"><I>The accompanying notes are an integral part of these Condensed 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">3 </P>

</DIV></Center>


<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>


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx558671_4"></A>MEDNAX, INC. </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>CONDENSED 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 per share data) </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(Unaudited) </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="66%"></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="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Three Months Ended</B><br><B>June&nbsp;30,</B></TD>
<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>Six Months Ended</B><br><B>June&nbsp;30,</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>2018</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>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>2018</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>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">Net revenue</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">915,918</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">842,944</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,817,775</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,678,541</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: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">620,980</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">1,252,810</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,133,803</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">31,833</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">62,488</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">58,668</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">107,908</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">216,684</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">206,780</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">26,518</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">52,681</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">51,349</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">787,239</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">1,584,663</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,450,600</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">128,679</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">233,112</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">227,941</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">1,202</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">2,666</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">941</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">(21,604</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">(41,539</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(36,287</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">1,257</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">2,782</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,486</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">(19,145</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">(36,091</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(33,860</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:5.00em; 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">109,534</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">197,021</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">194,081</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">(30,122</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">(54,181</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(75,692</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">$</TD>
<TD VALIGN="bottom" ALIGN="right">79,412</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">63,698</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">142,840</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">118,389</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:</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="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">Net income:</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="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: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">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.85</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.69</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.54</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.28</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">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.85</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.69</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.53</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.27</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="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">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 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: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">92,987</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">92,922</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,270</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">93,529</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">93,516</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,977</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="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 Condensed 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">4 </P>

</DIV></Center>


<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>


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx558671_5"></A>MEDNAX, INC. </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>CONDENSED 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="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(Unaudited) </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="84%"></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="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Six&nbsp;Months&nbsp;Ended&nbsp;June&nbsp;30,</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>2018</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>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">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></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">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">142,840</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">118,389</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">Adjustments to reconcile net income to net cash 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></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">52,681</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">51,349</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">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">2,212</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,740</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">Stock-based compensation expense</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">20,399</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">14,781</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">Deferred income taxes</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(21,211</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">18,454</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">Other</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(2,148</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(3,407</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">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></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">Accounts receivable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(23,998</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">18,361</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:7.00em; text-indent:-1.00em; font-size:10pt; 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">(1,178</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(666</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">Other long term assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(317</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(3,425</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:7.00em; 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">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(100,442</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(87,862</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">Income taxes payable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(39,909</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(15,900</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:7.00em; text-indent:-1.00em; font-size:10pt; 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">(65</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(299</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">Long-term professional liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(5,863</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,016</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:7.00em; 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">(1,397</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">2,282</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></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:9.00em; text-indent:-1.00em; font-size:10pt; 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">21,604</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">115,813</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></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">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></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">Acquisition payments, net of cash acquired</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(25,575</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(113,746</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">Purchases of investments</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(15,884</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(15,324</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">Proceeds from maturities of investments</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,995</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">7,290</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">Purchases of property and equipment</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(26,274</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(21,909</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">Proceeds from sale of controlling interest in assets</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">22,764</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:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Other</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">3,868</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></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:9.00em; text-indent:-1.00em; font-size:10pt; 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">(38,974</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(139,821</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></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">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></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">Borrowings on credit agreement</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">821,500</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">821,000</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:3.00em; text-indent:-1.00em; font-size:10pt; 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">(782,500</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(754,000</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">Payments of contingent consideration liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(367</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(1,961</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">Payments on capital lease obligations</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(636</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(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:3.00em; text-indent:-1.00em; font-size:10pt; 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">9,389</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">13,990</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">Repurchases of common stock</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(52,160</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</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="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">Contribution from 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">894</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></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:9.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Net cash (used in) provided from financing activities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(4,774</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">8,733</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></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 decrease in cash and cash equivalents</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(22,144</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(15,275</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">Cash, cash equivalents and restricted cash at beginning of period</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">80,200</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">55,698</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></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">Cash, cash equivalents and restricted cash at end of period</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">58,056</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">40,423</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></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 Condensed 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">5 </P>

</DIV></Center>


<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>


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx558671_6"></A>MEDNAX, INC. </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>June&nbsp;30, 2018 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(Unaudited) </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"><B>1.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Basis of Presentation and New Accounting Pronouncements: </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">The accompanying unaudited Condensed Consolidated Financial Statements of the Company and the notes thereto presented in this <FONT
STYLE="white-space:nowrap">Form&nbsp;10-Q</FONT> have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (&#147;SEC&#148;) applicable to interim financial statements, and do not include all
disclosures required by accounting principles generally accepted in the United States of America (&#147;GAAP&#148;) for complete financial statements. In the opinion of management, these financial statements include all adjustments, consisting only
of normal recurring adjustments, necessary for a fair statement of the results of interim periods. The financial statements include all the accounts of MEDNAX, Inc. and its consolidated subsidiaries (collectively, &#147;MDX&#148;) together with the
accounts of MDX&#146;s affiliated business corporations or professional associations, professional corporations, limited liability companies and partnerships (the &#147;affiliated professional contractors&#148;). Certain subsidiaries of MDX have
contractual management arrangements with its affiliated professional contractors, which are separate legal entities that provide physician services in certain states and Puerto Rico. The terms &#147;MEDNAX&#148; and the &#147;Company&#148; refer
collectively to MEDNAX, Inc., its subsidiaries and the affiliated professional contractors. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company is a party to a
joint venture in which it owns a 37.5% economic interest. In January 2018, the Company entered into an additional joint venture in which it owns a 49.0% economic interest. The Company accounts for these joint ventures under the equity method of
accounting because the Company exercises significant influence over, but does not control, these entities. See Note 5 for more information regarding the January 2018 joint venture. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">The consolidated results of operations for the interim periods presented are not necessarily indicative of the results to be
experienced for the entire fiscal year. In addition, the accompanying unaudited Condensed Consolidated Financial Statements and the notes thereto should be read in conjunction with the Consolidated Financial Statements and the notes thereto included
in the Company&#146;s most recent Annual Report on <FONT STYLE="white-space:nowrap">Form&nbsp;10-K</FONT> (the &#147;Form <FONT STYLE="white-space:nowrap">10-K&#148;).</FONT> </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman"><B>Recently Adopted Accounting Pronouncements </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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. The guidance became effective for the Company on January&nbsp;1, 2018 and was adopted on a full retrospective basis. 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, 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 did not have an
impact on our Consolidated Financial Statements, other than increased financial statement disclosures. The guidance requires increased disclosures, including qualitative and quantitative disclosures about the nature, amount, timing and uncertainty
of revenue and cash flows arising from contracts with customers. See Note 4 for more information. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman"><B>New Accounting Pronouncements
</B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 has completed the review of its existing lease portfolio and is accumulating all
of the necessary information required to properly account for leases under the new guidance. The Company has selected a software application, inclusive of a lease administration module and an accounting module, and has begun the implementation
process. The Company is in the process of designing workflows, business processes and internal controls surrounding the lease accounting process in order to meet the reporting and disclosure requirements. The Company&#146;s implementation and
continued evaluation of this new guidance and its impacts are expected to continue through the third quarter of 2018. </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>

</DIV></Center>


<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>


<Center><DIV STYLE="width:8.5in" align="left">

<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.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Cash Equivalents and Investments: </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">As of June&nbsp;30, 2018 and December&nbsp;31, 2017, the Company&#146;s cash equivalents consisted entirely of money market
funds totaling $2.4&nbsp;million and $9.2&nbsp;million, respectively. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 and equity securities. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">Investments held at June&nbsp;30, 2018 and December&nbsp;31, 2017 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="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>
<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="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>June&nbsp;30, 2018</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, 2017</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">$</TD>
<TD VALIGN="bottom" ALIGN="right">8,432</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">48,613</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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 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">36,393</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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">1,470</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,180</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">4,165</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">$</TD>
<TD VALIGN="bottom" ALIGN="right">9,902</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">90,186</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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></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; margin-left:4%; 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="68%"></TD>
<TD VALIGN="bottom" WIDTH="10%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="10%"></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>June&nbsp;30,&nbsp;2018</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>December&nbsp;31,&nbsp;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">Due after one year through five years</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">89,186</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">78,561</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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">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">2,121</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">$</TD>
<TD VALIGN="bottom" ALIGN="right">90,186</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">80,682</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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="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>3.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Fair Value Measurements: </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 June&nbsp;30, 2018 and December&nbsp;31, 2017, the Company&#146;s money market funds had a carrying amount of $2.4&nbsp;million and $9.2&nbsp;million, respectively. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 June&nbsp;30, 2018 and December&nbsp;31, 2017, the Company&#146;s cash
surrender value of life insurance had a carrying amount of $15.7&nbsp;million and $15.6&nbsp;million, respectively. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 June&nbsp;30, 2018 and
December&nbsp;31, 2017, the Company&#146;s contingent consideration liabilities had a fair value of $30.7&nbsp;million and $30.5&nbsp;million, respectively. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 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 was measured at fair value, it would be categorized as Level&nbsp;2 in the fair value hierarchy. The estimated fair value of the
Company&#146;s 5.25% senior unsecured notes due 2023 was $735.0&nbsp;million and $763.1&nbsp;million, at June&nbsp;30, 2018 and December&nbsp;31, 2017, respectively, and was estimated using trading prices on such dates as Level&nbsp;2 inputs to
estimate fair value. </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">7 </P>

</DIV></Center>


<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>


<Center><DIV STYLE="width:8.5in" align="left">

<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>4.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Accounts Receivable and Net Revenue: </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; 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="68%"></TD>
<TD VALIGN="bottom" WIDTH="7%"></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 ; 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>June&nbsp;30, 2018</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>December&nbsp;31,&nbsp;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">Gross accounts receivable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,918,787</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,790,034</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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">(1,390,790</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</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></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">$</TD>
<TD VALIGN="bottom" ALIGN="right">527,997</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">503,999</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">Patient service revenue is recognized at the time services are provided by the Company&#146;s
affiliated physicians. The Company&#146;s performance obligations related to the delivery of services to patients are satisfied at the time of service. Accordingly, there are no performance obligations that are unsatisfied or partially unsatisfied
at the end of the reporting period with respect to patient service revenue. 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. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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;)
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 third-party insurance payors for such
services. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">Collection of patient service revenue the Company expects to receive is normally a function of providing
complete and correct billing information to the government-sponsored healthcare programs and third-party insurance payors within the various filing deadlines and typically occurs within&nbsp;30&nbsp;to&nbsp;60&nbsp;days of billing. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">Some of the Company&#146;s hospital agreements require hospitals to pay the Company administrative fees. Some agreements
provide for fees if the hospital does not generate sufficient patient volume in order to guarantee that the Company receives a specified minimum revenue level. The Company also receives fees from hospitals for administrative services performed by
its affiliated physicians providing medical director or other services at the hospital. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition, the Company generates
revenue through its management services organization 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. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">The following table summarizes the Company&#146;s net
revenue by category (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="60%"></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>
<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>Three Months Ended</B><br><B>June&nbsp;30,</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>Six Months Ended</B><br><B>June&nbsp;30,</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>2018</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>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2018</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">Net patient service revenue</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">763,667</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">708,739</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,520,040</TD>
<TD NOWRAP VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,414,192</TD>
<TD NOWRAP 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">Hospital contract administrative fees</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">95,534</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">75,604</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">186,773</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">147,869</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">Management services and other</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">56,717</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">58,601</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">110,962</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">116,480</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">$</TD>
<TD VALIGN="bottom" ALIGN="right">915,918</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">842,944</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,817,775</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1,678,541</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: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">8 </P>

</DIV></Center>


<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>


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">The approximate percentage of net patient service revenue by type of payor
was as follows: </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="72%"></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>
<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="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Three&nbsp;Months&nbsp;Ended</B><br><B>June&nbsp;30,</B></TD>
<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>Six&nbsp;Months&nbsp;Ended</B><br><B>June&nbsp;30,</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>2018</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>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>2018</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>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">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">71</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">71</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">24</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25</TD>
<TD NOWRAP VALIGN="bottom"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">24</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">4</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&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">4</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>
<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>
<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>
<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>
<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: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>5.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Business Acquisitions, Joint Ventures and Goodwill: </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the six months ended June&nbsp;30, 2018, the Company completed the acquisition of five physician group practices,
including two radiology practices, one neonatology practice and two pediatric subspecialty practices. The acquisition-date fair value of the total consideration for the five acquisitions was $24.4&nbsp;million. These acquisitions expanded the
Company&#146;s national network of physician practices. In connection with these acquisitions, the Company recorded goodwill of $15.5&nbsp;million and other intangible assets consisting primarily of physician and hospital agreements of $8.9 million.
</P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">In addition, during the six months ended June&nbsp;30, 2018, in connection with certain prior-period acquisitions, the
Company paid $0.4&nbsp;million for contingent consideration and $1.2&nbsp;million for purchase consideration that had been held back pending satisfaction of certain conditions. All amounts except for the accretion recorded during 2018 were accrued
as of December&nbsp;31, 2017. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">In connection with certain prior-period acquisitions, the Company also recorded a decrease
in current assets of $1.2&nbsp;million, a decrease in noncurrent assets of $1.5&nbsp;million, an increase in current liabilities of $1.4&nbsp;million and an increase in noncurrent liabilities of $1.2&nbsp;million, with a corresponding net increase
in goodwill of $5.3&nbsp;million for measurement-period adjustments resulting from the finalization of acquisition accounting. The Company expects that $18.2&nbsp;million of the goodwill recorded during the six months ended June&nbsp;30, 2018 will
be deductible for tax purposes. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">In January 2018, the Company completed the sale of a controlling interest and the
contribution of remaining assets to a joint venture related to the $46.0&nbsp;million of assets held for sale at December&nbsp;31, 2017. The Company accounts for its 49.0% economic interest in the joint venture as an equity method investment. The
investment in this joint venture is included in other assets as presented in the Company&#146;s Condensed Consolidated Balance Sheet. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">The Company&#146;s management services reporting unit has experienced lower operating results than previously forecasted
primarily due to a slower rate of new customer bookings and an increase in customer termination activity. The Company continues to believe that the fair value of the reporting unit exceeds the carrying value, and accordingly the goodwill assigned to
the management services reporting unit is not impaired&nbsp;Although the Company believes that the current assumptions and estimates used in its goodwill analysis are reasonable, supportable and appropriate, continued efforts to maintain or improve
the performance of this business could be impacted by unfavorable or unforeseen changes which could impact the existing assumptions used in the impairment analysis. Various factors could reasonably be expected to unfavorably impact existing
assumptions, primarily delays in new customer bookings and the related delay in revenue from new customers, increases in customer termination activity or increases in operating costs. Accordingly, there can be no assurance that the estimates and
assumptions made for the purposes of the goodwill impairment analysis will prove to be accurate predictions of future performance. The carrying value of the Company&#146;s management services reporting unit included goodwill of $321.6&nbsp;million
as of June&nbsp;30, 2018. The Company will continue to closely monitor the performance of the management services reporting unit. If an impairment loss is required in a future period, it could have a material adverse effect on the Company&#146;s
business, financial condition, results of operations, cash flows and the trading price of the Company&#146;s 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">9 </P>

</DIV></Center>


<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>


<Center><DIV STYLE="width:8.5in" align="left">

<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>6.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Accounts Payable and Accrued Expenses: </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">Accounts payable and accrued expenses consist 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="68%"></TD>
<TD VALIGN="bottom" WIDTH="9%"></TD>
<TD></TD>
<TD></TD>
<TD></TD>
<TD VALIGN="bottom" WIDTH="9%"></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>June&nbsp;30,&nbsp;2018</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>December&nbsp;31,&nbsp;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">Accounts payable</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">28,377</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">34,632</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">Accrued salaries and bonuses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">144,911</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">225,429</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">Accrued payroll taxes and benefits</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">71,379</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">75,672</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">Accrued professional liabilities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">35,253</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">37,912</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">Accrued contingent consideration</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">26,783</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">6,259</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">Accrued interest</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5,077</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,495</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 accrued expenses</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">46,475</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">53,618</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"></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">358,255</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">438,017</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD></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; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">The net decrease in accrued salaries and bonuses of $80.5&nbsp;million from December&nbsp;31,
2017 to June&nbsp;30, 2018 is primarily due to the payment of performance-based incentive compensation, principally to the Company&#146;s physicians, partially offset by performance-based incentive compensation accrued during the six months ended
June&nbsp;30, 2018. A majority of the Company&#146;s payments for performance-based incentive compensation is paid annually during the first quarter. </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>7.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Common and Common Equivalent Shares: </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">The
calculation of shares used in the basic and diluted net income per common share calculation for the three and six months ended June&nbsp;30, 2018 and 2017 is 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="72%"></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="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Three&nbsp;Months&nbsp;Ended</B><br><B>June&nbsp;30,</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>Six Months Ended</B><br><B>June&nbsp;30,</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>2018</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>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2018</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">Weighted average number of common shares outstanding</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,987</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&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;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,922</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,270</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">Weighted average number of dilutive common share equivalents</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">542</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">631</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">594</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">707</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 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">Weighted average number of common and common equivalent shares outstanding</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,529</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&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;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">93,516</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">92,977</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>
<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">Antidilutive securities not included in the diluted net income per common share
calculation</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">392</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">8</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">197</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">5</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="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><B>8.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Stock Incentive Plans and Stock Purchase Plans: </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 and service-based conditions. The Company recognizes compensation expense related to its restricted stock and deferred
stock awards ratably over the corresponding vesting periods. During the six months ended June&nbsp;30, 2018, the Company granted 597,550 shares of restricted stock to its employees and <FONT STYLE="white-space:nowrap">non-employee</FONT> directors
under the Amended and Restated 2008 Incentive Plan. At June&nbsp;30, 2018, the Company had 2.3&nbsp;million shares available for future grants and awards under its Amended and Restated 2008 Incentive Plan. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 <FONT STYLE="white-space:nowrap">non-employee</FONT> 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. </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">10 </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">Each of the ESPP and the SPP provide for the issuance of an aggregate of
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 six months ended June&nbsp;30, 2018, 182,888 shares in aggregate were issued under the ESPP and SPP. At June&nbsp;30, 2018, the Company had approximately 1.8&nbsp;million
shares in aggregate reserved for issuance under the ESPP and SPP. </P> <P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the three and six months ended June&nbsp;30, 2018
and 2017, the Company recognized stock-based compensation expense of $10.5&nbsp;million and $20.4&nbsp;million, and $7.3&nbsp;million and $14.8&nbsp;million, respectively. </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>9.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Common Stock Repurchase Program: </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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. During the six months ended June&nbsp;30, 2018, the Company repurchased 1.2&nbsp;million shares of its common stock
for $52.2&nbsp;million, inclusive of 54,909 shares withheld to satisfy minimum statutory withholding obligations of $2.5&nbsp;million in connection with the vesting of restricted stock and stock option exercises during the three months ended
June&nbsp;30, 2018. The shares repurchased by the Company during the second quarter of 2018 completed the repurchases under the program with respect to issuances of shares under the Company&#146;s equity compensation programs during 2018. 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. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TR style = "page-break-inside:avoid">
<TD WIDTH="4%" VALIGN="top" ALIGN="left"><B>10.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Commitments and Contingencies: </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 securities. The Company has not included an accrual for these matters as of June&nbsp;30, 2018 in its Condensed 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. </P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 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:6pt; margin-bottom:0pt; margin-left:4%; 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: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">11 </P>

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<TD WIDTH="8%" VALIGN="top" ALIGN="left"><B><A NAME="tx558671_7"></A>Item&nbsp;2.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Management&#146;s Discussion and Analysis of Financial Condition and Results&nbsp;of Operations
</B></P></TD></TR></TABLE> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 the unaudited Condensed Consolidated Financial Statements and the notes thereto included in this Quarterly
Report. In addition, reference is made to our audited consolidated financial statements and notes thereto and related Management&#146;s Discussion and Analysis of Financial Condition and Results of Operations included in our most recent Annual
Report on Form <FONT STYLE="white-space:nowrap">10-K.</FONT> As used in this Quarterly Report, 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. The following discussion contains forward-looking statements. Please see the Company&#146;s most recent Annual Report on Form <FONT STYLE="white-space:nowrap">10-K,</FONT> including Item 1A, Risk
Factors, for a discussion of the uncertainties, risks and assumptions associated with these forward-looking statements. In addition, please see &#147;Caution Concerning Forward-Looking Statements&#148; below. </P>
<P STYLE="margin-top:18pt; 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. Our national network is comprised of affiliated physicians who provide clinical care in 39
states and Puerto Rico. Our affiliated physicians provide neonatal clinical care, primarily within hospital-based neonatal intensive care units, to babies born prematurely or with medical complications; anesthesia care to patients in connection with
surgical and other procedures, as well as pain management; radiology services including diagnostic imaging and interventional radiology; and 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 those who provide pediatric intensive care, pediatric cardiology care, hospital-based pediatric care, pediatric
surgical care, pediatric ear, nose and throat, pediatric ophthalmology and pediatric urology services. MEDNAX also provides teleradiology services in all 50 states, the District of Columbia and Puerto Rico through a network of 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. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>2018 Acquisition Activity </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the six months ended June&nbsp;30, 2018, we completed the acquisitions of five physician group practices, including two radiology
practices, one neonatology practice and two pediatric subspecialty practices. 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. In addition, we believe that 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 a physician group&#146;s efficiency, provide subspecialty access and help them grow and remain competitive. We believe that radiology
physician group practice physicians can complement the staffing needs for our teleradiology services business during certain times, such as nights and weekends, when the group practice physicians are not providing services at their practices. Our
results of operations for the three and six months ended June&nbsp;30, 2018 include the results for these five acquisitions from their respective dates of acquisition and therefore are not comparable in some respects to our results of operations for
prior periods. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Corporate and Operational Initiatives </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We have developed a number of strategic initiatives across our organization, in both our corporate functions and our operational
infrastructure, with a goal of generating improvements in our general and administrative expenses and improvements through operational plans. In our corporate departments, we are focused on <FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">best-in-class</FONT></FONT> cost and service excellence in order to improve processes, use our resources more efficiently and utilize our scale more effectively in all areas of our operations. Within our operational
infrastructure, we have developed specific operational plans within each of our service lines and affiliated physician practices, with specific milestones and regular reporting, with the goal of generating long-term operational improvements and
fostering even greater collaboration across our national medical group. We are targeting annualized financial improvements related to these initiatives of $40&nbsp;million within general and administrative expenses and $80&nbsp;million in
operational improvements by the end of 2019, although there is no assurance that these improvements will be obtained. We believe these strategic initiatives, together with our continued plans to invest in focused, targeted and strategic organic and
acquisitive growth, position us well to deliver a differentiated value proposition to our stakeholders while continuing to provide the highest quality care for our patients. </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">12 </P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Common Stock Repurchase Program </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In July 2013, our board of directors authorized the repurchase of shares of our common stock up to an amount sufficient to offset the dilutive
impact from the issuance of shares under our equity compensation programs. The share repurchase program allows us 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 our common stock to offset the dilutive impact from the issuance of shares, if any, related to our acquisition
program. During the six months ended June&nbsp;30, 2018, we repurchased 1.2&nbsp;million shares of our common stock for $52.2&nbsp;million, inclusive of 54,909 shares withheld to satisfy minimum statutory withholding obligations of $2.5&nbsp;million
in connection with the vesting of restricted stock and exercises of stock options during the three months ended June&nbsp;30, 2018. The shares repurchased by us during the second quarter of 2018 completed the repurchases under the repurchase program
with respect to issuances of shares under our equity compensation programs during 2018. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">On August&nbsp;2, 2018, we announced that our
board of directors had authorized the repurchase of up to $500.0&nbsp;million of shares of our common stock in addition to our existing share repurchase program. We intend to commence repurchases under this program in the near term. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We may 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. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>General Economic Conditions and Other Factors </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our operations and performance depend significantly on economic conditions. During the three months ended June&nbsp;30, 2018, the percentage of
our patient service revenue being reimbursed under government-sponsored or funded healthcare programs (the &#147;GHC Programs&#148;), decreased as compared to the three months ended March&nbsp;31, 2018 but increased as compared to the three months
ended June&nbsp;30, 2017. We could experience shifts toward GHC Programs and patient volumes could decline if economic conditions deteriorate or changes occur in population demographics within geographic locations in which we provide services.
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 lower net revenue resulting from increased bad debt due to patients&#146; inability to pay for certain services. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Healthcare Reform
</I></B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 the 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. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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. </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">13 </P>

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<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>The Medicare Access and CHIP Reauthorization Act </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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
currently anticipate that our affiliated physicians will be eligible to receive bonus payments in 2019 through participation in the MIPS, although the amounts of such bonus payments are not expected to be material. 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. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Medicaid Expansion </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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. To date, 32 states and the District of Columbia have expanded Medicaid eligibility to cover this additional low income patient population,
and 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. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Medicare Sequestration </I></B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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, apply to mandatory and discretionary spending through 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. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I><FONT STYLE="white-space:nowrap">Non-GAAP</FONT> Measures </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 before interest expense, income tax provision and depreciation and amortization. Prior to the fourth quarter of 2017, the Company had included
immaterial investment and other income and equity in earnings of unconsolidated affiliates as a component of the interest expense adjustment within EBITDA. Beginning with the fourth quarter of 2017, the Company began excluding these items such that
the interest expense adjustment represents only interest expense and has conformed its historical EBITDA calculations with the current presentation. Adjusted earnings per common share (&#147;Adjusted EPS&#148;) consists of diluted net income per
common and common equivalent share adjusted for amortization expense and stock-based compensation expense. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We believe these measures, in
addition to income from operations, net income and diluted net income 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. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">For a reconciliation of each of EBITDA and Adjusted EPS to the most directly comparable GAAP measures for the three and six months ended
June&nbsp;30, 2018 and 2017, 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-Q.</FONT> </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">14 </P>

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<Center><DIV STYLE="width:8.5in" align="left">

<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="64%"></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>
<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>Three Months Ended</B><br><B>June&nbsp;30,</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>Six Months Ended</B><br><B>June&nbsp;30,</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>2018</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>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2018</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">Net income</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">79,412</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">63,698</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">142,840</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">118,389</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">Interest expense</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">21,604</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&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;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">41,539</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">36,287</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 tax provision</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">30,122</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&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;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">54,181</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">75,692</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">26,518</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&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;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">52,681</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">51,349</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 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">EBITDA</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">157,656</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">148,693</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">291,241</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">281,717</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="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="72%"></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>
<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="14" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Three Months Ended</B><br><B>June&nbsp;30,</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="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2018</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>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">Weighted average diluted shares outstanding</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5" ALIGN="center">93,529</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5" ALIGN="center">92,812</TD>
<TD 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 and diluted net income per share</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">79,412</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.85</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">63,698</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.69</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">Adjustments:</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>
<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">Amortization (net of tax of $4,822 and $6,800)</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">12,713</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.14</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">10,636</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.11</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">Stock-based compensation (net of tax of $2,894 and $2,826)</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">7,630</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.08</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">4,420</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.05</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"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Adjusted net income and diluted EPS</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">99,755</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.07</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">78,754</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">0.85</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="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="70%"></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>
<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="14" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Six Months Ended</B><br><B>June&nbsp;30,</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="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>2018</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>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">Weighted average diluted shares outstanding</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5" ALIGN="center">93,516</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center">&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="5" ALIGN="center">92,977</TD>
<TD 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 and diluted net income per share</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">142,840</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.53</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">118,389</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.27</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">Adjustments:</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>
<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">Amortization (net of tax of $9,586 and $13,644)</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">25,273</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.27</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">21,340</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.23</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:3.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Stock-based compensation (net of tax of $5,609 and $5,764)</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">14,790</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</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;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">9,017</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">0.10</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"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">Adjusted net income and diluted EPS</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">182,903</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.96</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">148,746</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">1.60</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:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Results of Operations </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><I>Three Months Ended June&nbsp;30, 2018 as Compared to Three Months Ended June&nbsp;30, 2017 </I></B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our net revenue increased $73.0&nbsp;million, or 8.7%, to $915.9&nbsp;million for the three months ended June&nbsp;30, 2018, as compared to
$842.9&nbsp;million for the same period in 2017. Of this $73.0&nbsp;million increase, $46.7&nbsp;million, or 5.5%, was attributable to revenue generated from acquisitions completed after March&nbsp;31, 2017 and 26.3&nbsp;million, or 3.2%, was
attributable to an increase in same-unit net revenue. 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 an increase of
$15.5&nbsp;million, or 1.9%, related to patient service volumes and a net increase of $10.8&nbsp;million, or 1.3%, from net reimbursement-related factors. The increase in revenue of $15.5&nbsp;million from patient service volumes was related to
growth across all of our services. The net increase in revenue of $10.8&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.&nbsp;&nbsp;&nbsp;&nbsp; </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Practice salaries and benefits increased $59.6&nbsp;million, or 10.6%, to $621.0&nbsp;million for the three months ended June&nbsp;30, 2018,
as compared to $561.4&nbsp;million for the same period in 2017. This $59.6&nbsp;million increase was primarily attributable to increased costs associated with physicians and other staff to support organic-growth initiatives, acquisition-related
growth and growth at our existing units, of which $50.2&nbsp;million was related to salaries and $9.4&nbsp;million was related to benefits and incentive compensation. We anticipate that we will continue to experience a higher rate of growth in
clinician compensation expense at our existing units over historic averages, which could adversely affect our business, financial condition, results of operations, cash flows and the trading price of our securities. We anticipate that practice
salaries and benefits expense for the third and fourth quarters of 2018 will continue to include salaries and benefit costs for certain physicians who will remain employed through December&nbsp;31, 2018 despite the
<FONT STYLE="white-space:nowrap">non-renewal</FONT> of an anesthesia services contract by one of our hospital partners effective July&nbsp;1, 2018, under which they had previously provided services. </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">15 </P>

</DIV></Center>


<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>


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Practice supplies and other operating expenses increased $0.9&nbsp;million, or 3.1%, to
$31.8&nbsp;million for the three months ended June&nbsp;30, 2018, as compared to $30.9&nbsp;million for the same period in 2017. The increase was primarily attributable to practice supply, rent and other costs related to our acquisitions, partially
offset by decreases at our existing units. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 $4.9&nbsp;million, or 4.8%, to $107.9&nbsp;million for the three months ended June&nbsp;30, 2018, as compared
to $103.0&nbsp;million for the same period in 2017. The increase of $4.9&nbsp;million is attributable to the overall growth of the Company. Included within general and administrative expenses was an increase of $3.2&nbsp;million of stock-based
compensation expense primarily resulting from the change in timing of our annual equity grants from June to March in order to align the timing with other compensation related activities and a decrease of approximately $6.0&nbsp;million in cost
improvement as part of our corporate initiative. General and administrative expenses as a percentage of net revenue was 11.8% for the three months ended June&nbsp;30, 2018, as compared to 12.2% for the same period in 2017. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Depreciation and amortization expense increased $0.8&nbsp;million, or 3.0%, to $26.5&nbsp;million for the three months ended June&nbsp;30,
2018, as compared to $25.7&nbsp;million for the same period in 2017. The increase was primarily attributable to the amortization of intangible assets related to acquisitions. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Income from operations increased $6.8&nbsp;million, or 5.6%, to $128.7&nbsp;million for the three months ended June&nbsp;30, 2018, as compared
to $121.9&nbsp;million for the same period in 2017. Our operating margin was 14.1% for the three months ended June&nbsp;30, 2018, as compared to 14.5% for the same period in 2017. The decrease of 41 basis points was primarily due to higher operating
expense growth as compared to revenue growth. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Net <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses were $19.1&nbsp;million
for the three months ended June&nbsp;30, 2018, as compared to $17.5&nbsp;million for the same period in 2017. 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 interest rates on higher outstanding borrowings under our credit agreement (the &#147;Credit Agreement&#148;). </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our
effective income tax rate was 27.5% and 39.0% for the three months ended June&nbsp;30, 2018 and 2017, respectively. The decrease in our effective tax rate is primarily related to the reduction in the corporate tax rate enacted under the Tax Cuts and
Jobs Act of 2017.&nbsp;&nbsp;&nbsp;&nbsp; </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Net income was $79.4&nbsp;million for the three months ended June&nbsp;30, 2018, as compared to
$63.7&nbsp;million for the same period in 2017. EBITDA was $157.7&nbsp;million for the three months ended June&nbsp;30, 2018, as compared to $148.7&nbsp;million for the same period in 2017. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Diluted net income per common and common equivalent share was $0.85 on weighted average shares outstanding of 93.5&nbsp;million for the three
months ended June&nbsp;30, 2018, as compared to $0.69 on weighted average shares outstanding of 92.8&nbsp;million for the same period in 2017. Adjusted EPS was $1.07 for the three months ended June&nbsp;30, 2018, as compared to $0.85 for the same
period in 2017. </P> <P STYLE="margin-top:24pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><I>Six Months Ended June&nbsp;30, 2018 as Compared to Six Months Ended June&nbsp;30, 2017 </I></B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our net revenue increased $139.2&nbsp;million, or 8.3%, to $1.82&nbsp;billion for the six months ended June&nbsp;30, 2018, as compared to
$1.68&nbsp;billion for the same period in 2017. Of this $139.2&nbsp;million increase, $84.6&nbsp;million, or 4.9%, was attributable to revenue generated from acquisitions completed after December&nbsp;31, 2016 and $54.6&nbsp;million, or 3.4%, was
attributable to an increase in same-unit net revenue. 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
$28.7&nbsp;million, or 1.8%, related to patient service volumes and an increase of $25.9&nbsp;million, or 1.6%, from net reimbursement-related factors. The increase in revenue of $28.7&nbsp;million from patient service volumes was related to growth
across almost all of our services. The net increase in revenue of $25.9&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. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Practice salaries and benefits increased $119.0&nbsp;million, or 10.5%, to $1.25&nbsp;billion for the six months ended June&nbsp;30, 2018, as
compared to $1.13&nbsp;billion for the same period in 2017. This $119.0&nbsp;million increase was primarily attributable to increased costs associated with physicians and other staff primarily to support organic-growth initiatives,
acquisition-related growth and growth at our existing units, of which $96.9&nbsp;million was related to salaries and $22.1&nbsp;million was related to benefits and incentive compensation. We anticipate that we will continue to experience a higher
rate of growth in compensation expense at our existing units over historic averages, which could adversely affect our business, financial condition, results of operations, cash flows and the trading price of our securities. We anticipate that
practice salaries and benefits expense for the third and fourth quarters of 2018 will continue to include salaries and benefit costs for certain physicians who will remain employed through December&nbsp;31, 2018 despite the <FONT
STYLE="white-space:nowrap">non-renewal</FONT> of an anesthesia services contract with one of our hospital partners effective July&nbsp;1, 2018, under which they had previously provided services. </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">16 </P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Practice supplies and other operating expenses increased $3.8&nbsp;million, or 6.5%, to
$62.5&nbsp;million for the six months ended June&nbsp;30, 2018, as compared to $58.7&nbsp;million for the same period in 2017. The increase was primarily attributable to practice supply, rent and other costs related to our acquisitions, partially
offset by decrease at our existing units. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 $9.9&nbsp;million, or 4.8%, to $216.7&nbsp;million for the six months ended June&nbsp;30, 2018, as compared
to $206.8&nbsp;million for the same period in 2017. The net increase of $9.9&nbsp;million is attributable to the overall growth of the Company, including growth from acquisitions. Included within general and administrative expenses was an increase
of $5.4&nbsp;million of stock-based compensation expense primarily resulting from the change in timing of our annual equity grants from June to March in order to align the timing with other compensation related activities and a decrease of
$12.0&nbsp;million in cost improvement as part of our corporate initiative. General and administrative expenses as a percentage of net revenue was 11.9% for the six months ended June&nbsp;30, 2018, as compared to 12.3% for the same period in 2017.
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Depreciation and amortization expense increased $1.4&nbsp;million, or 2.6%, to $52.7&nbsp;million for the six months ended June&nbsp;30,
2018, as compared to $51.3&nbsp;million for the same period in 2017. The increase was primarily attributable to the amortization of intangible assets related to acquisitions. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Income from operations increased $5.2&nbsp;million, or 2.3%, to $233.1&nbsp;million for the six months ended June&nbsp;30, 2018, as compared
to $227.9&nbsp;million for the same period in 2017. Our operating margin was 12.8% for the six months ended June&nbsp;30, 2018, as compared to 13.6% for the same period in 2017. The decrease of 76 basis points was due to higher operating expense
growth as compared to revenue growth. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Net <FONT STYLE="white-space:nowrap">non-operating</FONT> expenses were $36.1&nbsp;million for the
six months ended June&nbsp;30, 2018, as compared to $33.9&nbsp;million for the same period in 2018. 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 interest rates on higher outstanding borrowings under our Credit Agreement. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our effective income tax rate was 27.5% and
39.0% for the six months ended June&nbsp;30, 2018 and 2017, respectively. The decrease in our effective tax rate is primarily related to the reduction in the corporate tax rate enacted under the Tax Cuts and Jobs Act of 2017.&nbsp;&nbsp;&nbsp;&nbsp;
</P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Net income was $142.8&nbsp;million for the six months ended June&nbsp;30, 2018, as compared to $118.4&nbsp;million for the same period in
2017. EBITDA was $291.2&nbsp;million for the six months ended June&nbsp;30, 2018, as compared to $281.7&nbsp;million for the same period in 2017. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Diluted net income per common and common equivalent share was $1.53 on weighted average shares outstanding of 93.5&nbsp;million for the six
months ended June&nbsp;30, 2018, as compared to $1.27 on weighted average shares outstanding of 93.0&nbsp;million for the same period in 2017. Adjusted EPS was $1.96 for the six months ended June&nbsp;30, 2018, as compared to $1.60 for the same
period in 2017. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Liquidity and Capital Resources </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">As of June&nbsp;30, 2018, we had $38.1&nbsp;million of cash and cash equivalents on hand as compared to $60.2&nbsp;million at December&nbsp;31,
2017. Additionally, we had working capital of $213.7&nbsp;million at June&nbsp;30, 2018, an increase of $117.9&nbsp;million from working capital of $95.8&nbsp;million at December&nbsp;31, 2017. This net increase in working capital is primarily due
to <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap">year-to-date</FONT></FONT> earnings and net borrowings on our Credit Agreement, partially offset by the use of funds for repurchases of our common stock and acquisitions. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Cash Flows </I></B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">Cash provided by
(used in) operating, investing and financing activities is 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="77%"></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="6" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Six Months Ended</B><br><B>June&nbsp;30,</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>2018</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">Operating activities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">21,604</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">115,813</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">Investing activities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(38,974</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(139,821</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">Financing activities</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(4,774</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">8,733</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">17 </P>

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 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Operating Activities </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the six months ended June&nbsp;30, 2018, our net cash provided from operating activities was $21.6&nbsp;million, compared to
$115.8&nbsp;million for the same period in 2017. The net decrease in cash provided of $94.2&nbsp;million was primarily due to increases in accounts receivable, a decrease in cash flow from income taxes resulting from tax payments made in the first
quarter of 2018 for 2017 taxes that were deferred by the Internal Revenue Service for companies impacted by the 2017 hurricanes, partially offset by an increase in cash flow related to higher earnings. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the six months ended June&nbsp;30, 2018, cash flow from accounts receivable decreased by $24.0&nbsp;million, as compared to an increase
of $18.4&nbsp;million for the same period in 2017. The decrease in cash flow from accounts receivable for the six months ended June&nbsp;30, 2018 was primarily due to increased ending accounts receivable balances at existing units resulting from
higher same-unit revenue. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Days sales outstanding (&#147;DSO&#148;) 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. Our DSO was 52.5 days at
June&nbsp;30, 2018 as compared to 50.9 days at December&nbsp;31, 2017. The increase in our DSO primarily related to the increases in our accounts receivable balances at existing units. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Investing Activities </I></B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the
six months ended June&nbsp;30, 2018, our net cash used in investing activities of $39.0&nbsp;million primarily included capital expenditures of $26.3&nbsp;million, acquisition payments of $25.6&nbsp;million and net purchases of $9.9&nbsp;million
related to the purchase and maturity of investments, partially offset by proceeds of $22.8&nbsp;million related to the sale of the controlling interest in a group of assets to a third party. </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Financing Activities </I></B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the
six months ended June&nbsp;30, 2018, our net cash used in financing activities of $4.8&nbsp;million consisted primarily of the repurchase of $52.2&nbsp;million of our common stock, partially offset by net borrowings on our Credit Agreement of
$39.0&nbsp;million and proceeds of $9.4&nbsp;million from the exercise of employee stock options and the issuance of common stock under our 1996 <FONT STYLE="white-space:nowrap">Non-Qualified</FONT> Employee Stock Purchase Plan, as amended, and 2015
<FONT STYLE="white-space:nowrap">Non-Qualified</FONT> Stock Purchase Plan. </P> <P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B><I>Liquidity </I></B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Our 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 contractors. 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. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">At June&nbsp;30, 2018, 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 which reduced the amount available on our Credit Agreement to $850.3&nbsp;million at June&nbsp;30, 2018. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">At June&nbsp;30, 2018, the outstanding principal balance on our 5.25% senior unsecured notes due 2023 (the &#147;2023 Senior Notes&#148;) was
$750.0&nbsp;million. 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. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 </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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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. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">At June&nbsp;30, 2018, we
believe we were in compliance, in all material respects, with the financial covenants and other restrictions applicable to us under our Credit Agreement and the 2023 Senior Notes. We believe we will be in compliance with these covenants throughout
2018. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 June&nbsp;30, 2018 was
$242.9&nbsp;million, of which $35.3&nbsp;million is classified as a current liability within accounts payable and accrued expenses in the Condensed Consolidated Balance Sheet. In addition, there is a corresponding insurance receivable of
$16.7&nbsp;million recorded as a component of other assets for certain professional liability claims that are covered by insurance policies. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">On August&nbsp;2, 2018, we announced that our board of directors had authorized the repurchase of up to $500.0&nbsp;million of shares of our
common stock in addition to our existing share repurchase program. We intend to utilize various methods to effect the additional share repurchases, which are expected to commence in the near term. The amount and timing of repurchases will depend
upon several factors, including general economic and market conditions and trading restrictions. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 for at least the next 12 months from the date of issuance of this Form <FONT STYLE="white-space:nowrap">10-Q.</FONT> </P>
<P STYLE="margin-top:18pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman"><B>Caution Concerning Forward-Looking Statements </B></P>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Certain information included or incorporated by reference in this Quarterly Report may be deemed to be &#147;forward-looking statements&#148;
within the meaning of the Private Securities Litigation Reform Act of 1995, Section&nbsp;27A of the Securities Act of 1933, as amended, and Section&nbsp;21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements 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 are forward-looking statements. 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 Quarterly Report 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 the Company&#146;s most recent Annual Report on Form <FONT
STYLE="white-space:nowrap">10-K,</FONT> including the section entitled &#147;Risk Factors.&#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">19 </P>

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<TD WIDTH="8%" VALIGN="top" ALIGN="left"><B><A NAME="tx558671_8"></A>Item&nbsp;3.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Quantitative and Qualitative Disclosures about Market Risk </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 June&nbsp;30, 2018, the outstanding principal balance on our Credit Agreement was $1.1&nbsp;billion. Considering the total outstanding balance of $1.1&nbsp;billion, a 1.0% change in interest rates would result in an
impact to income before income taxes of approximately $11&nbsp;million per year. </P> <P STYLE="font-size:18pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
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<TD WIDTH="8%" VALIGN="top" ALIGN="left"><B><A NAME="tx558671_9"></A>Item&nbsp;4.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Controls and Procedures </B></P></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">The Company maintains 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 (the &#147;Exchange Act&#148;)) that are designed to provide reasonable assurance that information required to be disclosed by the Company in reports
it files or submits under the Exchange Act is (i)&nbsp;recorded, processed, summarized and reported within the time periods specified in SEC rules and forms and (ii)&nbsp;accumulated and communicated to the Company&#146;s management, including its
principal executive officer and principal financial officer, as appropriate to allow timely decisions regarding required disclosure. </P> <P STYLE="margin-top:12pt; 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 Exchange Act). Based upon that evaluation, the Chief Executive Officer and Chief Financial Officer have concluded that our disclosure
controls and procedures were effective at the reasonable assurance level 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>Changes in Internal
Controls 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 changes in our internal control over financial reporting occurred during the quarter ended
June&nbsp;30, 2018 that have materially affected, or are 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">20 </P>

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<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx558671_10"></A>PART II - OTHER INFORMATION </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="8%" VALIGN="top" ALIGN="left"><B><A NAME="tx558671_11"></A>Item&nbsp;1.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Legal Proceedings </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">We expect 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 our business, financial condition, results of operations, cash flows and the trading price of our
securities. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">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 or 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. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">Although we currently maintain liability insurance coverage intended to cover professional liability and certain other claims, we cannot
assure 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. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">On July&nbsp;10, 2018, a
securities class action lawsuit was filed against our company and certain of our officers and a director in the U.S. District Court for the Southern District of Florida (Case No. <FONT STYLE="white-space:nowrap"><FONT STYLE="white-space:nowrap"><FONT
STYLE="white-space:nowrap">0:18-cv-61572-WPD)</FONT></FONT></FONT> that purports to state a claim for alleged violations of Sections 10(b) and 20(a) of the Exchange Act, and Rule <FONT STYLE="white-space:nowrap">10b-5</FONT> thereunder, based on
statements made by the defendants primarily concerning our anesthesiology business. The complaint seeks unspecified damages, interest, attorneys&#146; fees and other costs. We believe this lawsuit to be without merit and intend to vigorously defend
against it. The lawsuit is in the very early stages and, at this time, no assessment can be made as to its likely outcome or whether the outcome will be material to us. </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="8%" VALIGN="top" ALIGN="left"><B><A NAME="tx558671_12"></A>Item&nbsp;1A.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Risk Factors </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">There have been no material changes to the risk factors previously disclosed in the Company&#146;s most recent Annual Report on Form <FONT
STYLE="white-space:nowrap">10-K.</FONT> </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="8%" VALIGN="top" ALIGN="left"><B><A NAME="tx558671_13"></A>Item&nbsp;2.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Unregistered Sales of Equity Securities and Use of Proceeds </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">During the three months ended June&nbsp;30, 2018, the Company repurchased 1.2&nbsp;million shares of its common stock for $52.2&nbsp;million,
inclusive of 54,909 shares withheld to satisfy minimum statutory withholding obligations of $2.5&nbsp;million in connection with the vesting of restricted stock and stock option exercises during the three months ended June&nbsp;30, 2018. </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="47%"></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>
<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 ; 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; display:table-cell; font-size:8pt; font-family:Times New Roman; "><B>Period</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" COLSPAN="2" ALIGN="center" STYLE="border-bottom:1.00pt solid #000000"><B>Total<BR>Number of<BR>Shares<BR>Purchased</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>Average</B><br><B>Price&nbsp;Paid<BR>per&nbsp;Share</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>Total&nbsp;Number&nbsp;of<BR>Shares&nbsp;Purchased&nbsp;as<BR>part of the<BR>Repurchase&nbsp;Program</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>Approximate&nbsp;Dollar<BR>Value&nbsp;of&nbsp;Shares&nbsp;that<BR>May&nbsp;Yet&nbsp;Be&nbsp;Purchased<BR>Under the Repurchase<BR>Programs</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">April&nbsp;1 &#150; April&nbsp;30, 2018</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">$</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(a</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">May&nbsp;1 &#150; May&nbsp;31, 2018</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD NOWRAP VALIGN="bottom" ALIGN="right">&#151;&nbsp;&nbsp;</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(a</TD>
<TD NOWRAP VALIGN="bottom">)&nbsp;</TD></TR>
<TR BGCOLOR="#cceeff" STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman">June&nbsp;1 &#150; June&nbsp;30, 2018</P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,154,909</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">45.16</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,100,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(a</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"> <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;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,154,909</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">$</TD>
<TD VALIGN="bottom" ALIGN="right">45.16</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">1,100,000</TD>
<TD NOWRAP VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="right">(a</TD>
<TD NOWRAP VALIGN="bottom">)&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">(a)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">We have two active repurchase programs. Our July 2013 program allows us to repurchase shares of our common
stock up to an amount sufficient to offset the dilutive impact from the issuance of shares under our equity compensation programs, which was estimated to be approximately 1.1&nbsp;million shares for 2018. The shares repurchased by us during the
second quarter of 2018 completed the repurchases under our repurchase program with respect to expected issuances of shares under our equity compensation programs during 2018. Our August 2018 repurchase program allows us to repurchase up to an
additional $500.0&nbsp;million of shares of our common stock. </P></TD></TR></TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">The amount and timing of any future repurchases will
depend upon several factors, including general economic and market conditions and trading restrictions. </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">21 </P>

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


<Center><DIV STYLE="width:8.5in" align="left">

<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="8%" VALIGN="top" ALIGN="left"><B><A NAME="tx558671_14"></A>Item&nbsp;5.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Other Information </B></P></TD></TR></TABLE>
<P STYLE="margin-top:6pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">On July&nbsp;27, 2018, Ms.&nbsp;Vivian Lopez-Blanco informed the Company of her intent to retire as Chief Financial Officer and Treasurer of
the Company. The Company intends to conduct a formal search to identify a successor to Ms.&nbsp;Lopez-Blanco. Ms.&nbsp;Lopez-Blanco will remain in her current role with the Company throughout the search process until the appointment of her
successor, and for a transitional period thereafter. </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">22 </P>

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


<Center><DIV STYLE="width:8.5in" align="left">

<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="8%" VALIGN="top" ALIGN="left"><B><A NAME="tx558671_15"></A>Item&nbsp;6.</B></TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left"><B>Exhibits </B></P></TD></TR></TABLE> <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="4%"></TD>
<TD WIDTH="89%"></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; font-size:8pt; font-family:Times New Roman" ALIGN="center"><B>Exhibit</B></P>
<P STYLE="margin-top:0pt; margin-bottom:1pt; border-bottom:1.00pt solid #000000; display:table-cell; font-size:8pt; font-family:Times New Roman; " ALIGN="center"><B>No.</B></P></TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="bottom" ALIGN="center"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; border-bottom:1.00pt solid #000000; display:table-cell; font-size:8pt; font-family:Times New Roman; " ALIGN="center"><B>Description</B></P></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>31.1+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d558671dex311.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>31.2+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d558671dex312.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>32+</TD>
<TD VALIGN="bottom">&nbsp;&nbsp;</TD>
<TD VALIGN="top"><A HREF="d558671dex32.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="2%" VALIGN="top" ALIGN="left">+</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">Filed herewith. </P></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">23 </P>

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


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B><A NAME="tx558671_16"></A>SIGNATURES </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Pursuant to the requirements 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">


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<TD WIDTH="46%"></TD>
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<TD WIDTH="4%"></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"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="top"></TD>
<TD VALIGN="bottom">&nbsp;</TD>
<TD VALIGN="bottom" 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="bottom">Date: August&nbsp;2, 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="bottom"></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">Roger J. Medel, M.D.</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></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">Chief Executive Officer</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></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">(Principal Executive Officer)</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="bottom">Date: August&nbsp;2, 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/ Vivian Lopez-Blanco</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></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">Vivian Lopez-Blanco</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></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">Chief Financial Officer and Treasurer</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></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">(Principal Financial Officer)</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="bottom">Date: August&nbsp;2, 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/ John C. Pepia</P></TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></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">John C. Pepia</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></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">Chief Accounting Officer</TD></TR>
<TR STYLE="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
<TD VALIGN="bottom"></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">(Principal Accounting Officer)</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">24 </P>

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<DOCUMENT>
<TYPE>EX-31.1
<SEQUENCE>2
<FILENAME>d558671dex311.htm
<DESCRIPTION>EX-31.1
<TEXT>
<HTML><HEAD>
<TITLE>EX-31.1</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="right"><B>Exhibit 31.1 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>CERTIFICATION </B></P> <P STYLE="margin-top:6pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">I, Roger J. Medel, M.D.,
certify that: </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="4%">&nbsp;</TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left">1.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">I have reviewed this quarterly report on Form <FONT STYLE="white-space:nowrap">10-Q</FONT> of MEDNAX, Inc.;
</P></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%">&nbsp;</TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left">2.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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; </P></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%">&nbsp;</TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left">3.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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; </P></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%">&nbsp;</TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left">4.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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: </P></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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(a)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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; </P></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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(b)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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; </P></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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(c)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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 </P></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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(d)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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 </P></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%">&nbsp;</TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left">5.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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): </P></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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(a)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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 </P></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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(b)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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. </P></TD></TR></TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Date: August&nbsp;2, 2018 </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="6%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD WIDTH="92%"></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="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">Roger J. Medel, M.D.</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">Chief Executive Officer</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">(Principal Executive Officer)</TD></TR>
</TABLE></DIV>
</DIV></Center>

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</DOCUMENT>
<DOCUMENT>
<TYPE>EX-31.2
<SEQUENCE>3
<FILENAME>d558671dex312.htm
<DESCRIPTION>EX-31.2
<TEXT>
<HTML><HEAD>
<TITLE>EX-31.2</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="right"><B>Exhibit 31.2 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>CERTIFICATION </B></P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">I, Vivian Lopez-Blanco,
certify that: </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="4%">&nbsp;</TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left">1.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">I have reviewed this quarterly report on Form <FONT STYLE="white-space:nowrap">10-Q</FONT> of MEDNAX, Inc.;
</P></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%">&nbsp;</TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left">2.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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; </P></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%">&nbsp;</TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left">3.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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; </P></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%">&nbsp;</TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left">4.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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: </P></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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(a)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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; </P></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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(b)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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; </P></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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(c)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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 </P></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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(d)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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 </P></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%">&nbsp;</TD>
<TD WIDTH="4%" VALIGN="top" ALIGN="left">5.</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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): </P></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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(a)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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 </P></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="8%">&nbsp;</TD>
<TD WIDTH="5%" VALIGN="top" ALIGN="left">(b)</TD>
<TD ALIGN="left" VALIGN="top"> <P STYLE=" margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman; " ALIGN="left">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. </P></TD></TR></TABLE> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">Date: August&nbsp;2, 2018 </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="6%"></TD>
<TD VALIGN="bottom" WIDTH="2%"></TD>
<TD WIDTH="92%"></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="bottom"> <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">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">Chief Financial Officer and Treasurer</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">(Principal Financial Officer)</TD></TR>
</TABLE></DIV>
</DIV></Center>

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</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-32
<SEQUENCE>4
<FILENAME>d558671dex32.htm
<DESCRIPTION>EX-32
<TEXT>
<HTML><HEAD>
<TITLE>EX-32</TITLE>
</HEAD>
 <BODY BGCOLOR="WHITE">


<Center><DIV STYLE="width:8.5in" align="left">
 <P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="right"><B>Exhibit 32 </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>Certification Pursuant to 18 U.S.C Section&nbsp;1350 </B></P>
<P STYLE="margin-top:0pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman" ALIGN="center"><B>(Adopted by Section&nbsp;906 of the Sarbanes-Oxley Act of 2002) </B></P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">In connection with the Quarterly Report of MEDNAX, Inc. on Form <FONT STYLE="white-space:nowrap">10-Q</FONT> for the quarter ended
June&nbsp;30, 2018 (the &#147;Report&#148;), each of the undersigned hereby certifies, pursuant to Section&nbsp;906 of the Sarbanes-Oxley Act of 2002, that (i)&nbsp;the Report fully complies with the requirements of Section&nbsp;13(a) or 15(d) of
the Securities Exchange Act of 1934 and (ii)&nbsp;the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of MEDNAX, Inc. </P>
<P STYLE="margin-top:12pt; margin-bottom:0pt; text-indent:4%; font-size:10pt; font-family:Times New Roman">A signed original of this written statement required by Section&nbsp;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. </P> <P STYLE="margin-top:12pt; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman">August&nbsp;2, 2018 </P>
<P STYLE="font-size:12pt;margin-top:0pt;margin-bottom:0pt">&nbsp;</P>
<TABLE CELLSPACING="0" CELLPADDING="0" WIDTH="40%" BORDER="0" STYLE="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt">


<TR>
<TD WIDTH="7%"></TD>
<TD VALIGN="bottom" WIDTH="1%"></TD>
<TD WIDTH="92%"></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="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">Roger J. Medel, M.D.</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">Chief Executive Officer</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">(Principal Executive Officer)</TD></TR>
<TR STYLE="font-size:1pt">
<TD HEIGHT="16"></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="bottom"> <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">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">Chief Financial Officer and Treasurer</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">(Principal Financial Officer)</TD></TR>
</TABLE>
</DIV></Center>

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</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.INS
<SEQUENCE>5
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  <us-gaap:OperatingIncomeLoss contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_4_7">227941000</us-gaap:OperatingIncomeLoss>
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  <us-gaap:PaymentsToAcquireOtherPropertyPlantAndEquipment contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_22">21909000</us-gaap:PaymentsToAcquireOtherPropertyPlantAndEquipment>
  <us-gaap:PaymentsForRepurchaseOfCommonStock contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_32">70192000</us-gaap:PaymentsForRepurchaseOfCommonStock>
  <us-gaap:PaymentsToAcquireBusinessesNetOfCashAcquired contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_19">113746000</us-gaap:PaymentsToAcquireBusinessesNetOfCashAcquired>
  <us-gaap:PaymentForContingentConsiderationLiabilityFinancingActivities contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_29">1961000</us-gaap:PaymentForContingentConsiderationLiabilityFinancingActivities>
  <us-gaap:PaymentForContingentConsiderationLiabilityOperatingActivities contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_14">299000</us-gaap:PaymentForContingentConsiderationLiabilityOperatingActivities>
  <us-gaap:PaymentsForProceedsFromOtherInvestingActivities contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_24">-3868000</us-gaap:PaymentsForProceedsFromOtherInvestingActivities>
  <us-gaap:ProceedsFromIssuanceOfCommonStock contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_31">13990000</us-gaap:ProceedsFromIssuanceOfCommonStock>
  <us-gaap:ProceedsFromMinorityShareholders contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_33">894000</us-gaap:ProceedsFromMinorityShareholders>
  <us-gaap:ProceedsFromSaleMaturityAndCollectionsOfInvestments contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_21">7290000</us-gaap:ProceedsFromSaleMaturityAndCollectionsOfInvestments>
  <us-gaap:ProceedsFromLinesOfCredit contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_27">821000000</us-gaap:ProceedsFromLinesOfCredit>
  <us-gaap:RepaymentsOfLinesOfCredit contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_28">754000000</us-gaap:RepaymentsOfLinesOfCredit>
  <us-gaap:ProfitLoss contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_4_14">118389000</us-gaap:ProfitLoss>
  <us-gaap:RepaymentsOfLongTermCapitalLeaseObligations contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_30">998000</us-gaap:RepaymentsOfLongTermCapitalLeaseObligations>
  <us-gaap:ShareBasedCompensation contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_2_5">14781000</us-gaap:ShareBasedCompensation>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="shares" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_4_20">92977000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="shares" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_4_19">92270000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_4_3">58668000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_4_2">1133803000</md:PracticeSalariesAndBenefits>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0" unitRef="pure" decimals="2" id="id_13580812_B285F87F-7754-47A0-99A8-07DC96A57989_4_4">1.00</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0_3071347x3071755" unitRef="pure" decimals="2" id="id_13580812_B285F87F-7754-47A0-99A8-07DC96A57989_1004_1">0.24</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0_3071347x3080487" unitRef="pure" decimals="2" id="id_13580812_B285F87F-7754-47A0-99A8-07DC96A57989_2004_3">0.01</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0_3071347x3081046" unitRef="pure" decimals="2" id="id_13580812_B285F87F-7754-47A0-99A8-07DC96A57989_3004_2">0.04</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <md:PercentageOfNetPatientServiceRevenueByTypeOfPayor contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0_3071347x3281104" unitRef="pure" decimals="2" id="id_13580812_B285F87F-7754-47A0-99A8-07DC96A57989_4004_0">0.71</md:PercentageOfNetPatientServiceRevenueByTypeOfPayor>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0_3077210x3071341" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_1004_0">1678541000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0_3077210x3071532" unitRef="iso4217_USD" decimals="-3" id="id_13580812_CF86204F-CF62-46B3-A606-19AD68374232_2004_1">1414192000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0_3077210x3073813" unitRef="iso4217_USD" decimals="-3" id="id_13580812_CF86204F-CF62-46B3-A606-19AD68374232_3004_3">116480000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax contextRef="eol_PE10840---1810-Q0008_STD_181_20170630_0_3077210x3296576" unitRef="iso4217_USD" decimals="-3" id="id_13580812_CF86204F-CF62-46B3-A606-19AD68374232_4004_2">147869000</us-gaap:RevenueFromContractWithCustomerIncludingAssessedTax>
  <us-gaap:AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_304CFDE2-7C42-4B21-B148-96B18330DBD3_1_0">&lt;div&gt;
 &lt;table style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" border="0" cellpadding="0" cellspacing="0" width="100%"&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td width="4%" valign="top" align="left"&gt;&lt;b&gt;6.&lt;/b&gt;&lt;/td&gt;
 &lt;td align="left" valign="top"&gt;
 &lt;p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"&gt;&lt;b&gt;Accounts Payable and Accrued Expenses:&lt;/b&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 Accounts payable and accrued expenses consist of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="font-size:12pt;margin-top:0pt;margin-bottom:0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table cellspacing="0" cellpadding="0" width="76%" border="0" style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" align="center"&gt;
 &lt;tr&gt;
 &lt;td width="68%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="9%"&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="9%"&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 ; font-family:Times New Roman; font-size:8pt"&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 valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"&gt;
 &lt;b&gt;June&amp;#xA0;30,&amp;#xA0;2018&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 valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"&gt;
 &lt;b&gt;December&amp;#xA0;31,&amp;#xA0;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Accounts payable&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;28,377&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;34,632&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Accrued salaries and bonuses&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;144,911&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;225,429&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Accrued payroll taxes 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;71,379&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;75,672&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Accrued professional liabilities&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;35,253&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;37,912&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Accrued contingent consideration&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;26,783&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;6,259&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Accrued interest&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;5,077&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;4,495&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Other accrued 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;46,475&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;53,618&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px 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 ; font-family:Times New Roman; font-size:10pt"&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;358,255&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;438,017&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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:12pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 The net decrease in accrued salaries and bonuses of
 $80.5&amp;#xA0;million from December&amp;#xA0;31, 2017 to June&amp;#xA0;30,
 2018 is primarily due to the payment of performance-based incentive
 compensation, principally to the Company&amp;#x2019;s physicians,
 partially offset by performance-based incentive compensation
 accrued during the six months ended June&amp;#xA0;30, 2018. A majority
 of the Company&amp;#x2019;s payments for performance-based incentive
 compensation is paid annually during the first quarter.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock>
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  <us-gaap:CommitmentsAndContingenciesDisclosureTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_7FC3199A-0C6C-4790-B858-290407234307_1_0">&lt;div&gt;
 &lt;table style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" border="0" cellpadding="0" cellspacing="0" width="100%"&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td width="4%" valign="top" align="left"&gt;&lt;b&gt;10.&lt;/b&gt;&lt;/td&gt;
 &lt;td align="left" valign="top"&gt;
 &lt;p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"&gt;&lt;b&gt;Commitments and Contingencies:&lt;/b&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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 securities. The Company has not included an
 accrual for these matters as of June&amp;#xA0;30, 2018 in its Condensed
 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;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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;/p&gt;
 &lt;/div&gt;</us-gaap:CommitmentsAndContingenciesDisclosureTextBlock>
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 &lt;table style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" border="0" cellpadding="0" cellspacing="0" width="100%"&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td width="4%" valign="top" align="left"&gt;&lt;b&gt;8.&lt;/b&gt;&lt;/td&gt;
 &lt;td align="left" valign="top"&gt;
 &lt;p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"&gt;&lt;b&gt;Stock Incentive Plans and Stock Purchase
 Plans:&lt;/b&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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 and service-based conditions. The
 Company recognizes compensation expense related to its restricted
 stock and deferred stock awards ratably over the corresponding
 vesting periods. During the six months ended June&amp;#xA0;30, 2018,
 the Company granted 597,550 shares of restricted stock to its
 employees and &lt;font style="white-space:nowrap"&gt;non-employee&lt;/font&gt;
 directors under the Amended and Restated 2008 Incentive Plan. At
 June&amp;#xA0;30, 2018, the Company had 2.3&amp;#xA0;million shares
 available for future grants and awards under its Amended and
 Restated 2008 Incentive Plan.&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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 &lt;font style="white-space:nowrap"&gt;non-employee&lt;/font&gt; 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.&lt;/p&gt;
 &lt;p style="font-size:1px;margin-top:6px;margin-bottom:0px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 Each of the ESPP and the SPP provide for the issuance of an
 aggregate of 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 six months ended June&amp;#xA0;30, 2018, 182,888
 shares in aggregate were issued under the ESPP and SPP. At
 June&amp;#xA0;30, 2018, the Company had approximately 1.8&amp;#xA0;million
 shares in aggregate reserved for issuance under the ESPP and
 SPP.&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 During the three and six months ended June&amp;#xA0;30, 2018 and 2017,
 the Company recognized stock-based compensation expense of
 $10.5&amp;#xA0;million and $20.4&amp;#xA0;million, and $7.3&amp;#xA0;million
 and $14.8&amp;#xA0;million, respectively.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock>
  <dei:DocumentFiscalPeriodFocus contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_1B91FE88-9F1A-4FB4-A40D-8839F9133E50_1_4">Q2</dei:DocumentFiscalPeriodFocus>
  <dei:DocumentFiscalYearFocus contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_1B91FE88-9F1A-4FB4-A40D-8839F9133E50_1_3">2018</dei:DocumentFiscalYearFocus>
  <dei:DocumentType contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_1B91FE88-9F1A-4FB4-A40D-8839F9133E50_1_0">10-Q</dei:DocumentType>
  <us-gaap:DisaggregationOfRevenueTableTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_9E4B3176-ABAE-48DF-88C5-7F1F7346FA94_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The following table summarizes the Company&amp;#x2019;s net revenue by
 category (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="60%"&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;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;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;Three Months Ended&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;June&amp;#xA0;30,&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;Six Months Ended&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;June&amp;#xA0;30,&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;2018&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;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;2018&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;2017&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 patient service 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;763,667&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;708,739&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,520,040&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&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;1,414,192&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&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;
 Hospital contract administrative fees&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;95,534&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;75,604&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;186,773&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;147,869&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;
 Management services and other&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;56,717&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;58,601&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;110,962&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;116,480&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;915,918&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;842,944&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,817,775&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;1,678,541&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:DisaggregationOfRevenueTableTextBlock>
  <us-gaap:EarningsPerShareTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_AE2A707E-439B-464A-9CF7-051845E3851A_1_0">&lt;div&gt;
 &lt;table style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" border="0" cellpadding="0" cellspacing="0" width="100%"&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td width="4%" valign="top" align="left"&gt;&lt;b&gt;7.&lt;/b&gt;&lt;/td&gt;
 &lt;td align="left" valign="top"&gt;
 &lt;p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"&gt;&lt;b&gt;Common and Common Equivalent Shares:&lt;/b&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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.&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 The calculation of shares used in the basic and diluted net income
 per common share calculation for the three and six months ended
 June&amp;#xA0;30, 2018 and 2017 is as follows (in thousands):&lt;/p&gt;
 &lt;p style="font-size:12pt;margin-top:0pt;margin-bottom:0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table cellspacing="0" cellpadding="0" width="92%" border="0" style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" align="center"&gt;
 &lt;tr&gt;
 &lt;td width="72%"&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="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt"&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 valign="bottom" colspan="6" align="center" style="border-bottom:1.00pt solid #000000"&gt;
 &lt;b&gt;Three&amp;#xA0;Months&amp;#xA0;Ended&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;June&amp;#xA0;30,&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 valign="bottom" colspan="6" align="center" style="border-bottom:1.00pt solid #000000"&gt;&lt;b&gt;Six Months Ended&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;June&amp;#xA0;30,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt"&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 valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"&gt;&lt;b&gt;2018&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 valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"&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 valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"&gt;&lt;b&gt;2018&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 valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Weighted average number of common shares outstanding&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;92,987&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;92,181&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;92,922&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;92,270&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Weighted average number of dilutive common share equivalents&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;542&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;631&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;594&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;707&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px 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 ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Weighted average number of common and common equivalent shares
 outstanding&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;93,529&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;92,812&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;93,516&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;92,977&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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 ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Antidilutive securities not included in the diluted net income per
 common share calculation&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;392&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;197&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;5&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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:EarningsPerShareDiluted contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_3_17">1.53</us-gaap:EarningsPerShareDiluted>
  <dei:EntityCentralIndexKey contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_3AF2A964-DF95-44FF-8F0D-AD08CF55B931_1_2">0000893949</dei:EntityCentralIndexKey>
  <dei:EntityRegistrantName contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_3AF2A964-DF95-44FF-8F0D-AD08CF55B931_1_1">MEDNAX, INC.</dei:EntityRegistrantName>
  <us-gaap:FairValueDisclosuresTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_72610457-4093-4CFC-9CC9-B4F1EF2B31A1_1_0">&lt;div&gt;
 &lt;table style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" border="0" cellpadding="0" cellspacing="0" width="100%"&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td width="4%" valign="top" align="left"&gt;&lt;b&gt;3.&lt;/b&gt;&lt;/td&gt;
 &lt;td align="left" valign="top"&gt;
 &lt;p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"&gt;&lt;b&gt;Fair Value Measurements:&lt;/b&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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 June&amp;#xA0;30, 2018 and
 December&amp;#xA0;31, 2017, the Company&amp;#x2019;s money market funds had
 a carrying amount of $2.4&amp;#xA0;million and $9.2&amp;#xA0;million,
 respectively.&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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 June&amp;#xA0;30, 2018 and
 December&amp;#xA0;31, 2017, the Company&amp;#x2019;s cash surrender value of
 life insurance had a carrying amount of $15.7&amp;#xA0;million and
 $15.6&amp;#xA0;million, respectively.&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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 June&amp;#xA0;30, 2018 and
 December&amp;#xA0;31, 2017, the Company&amp;#x2019;s contingent
 consideration liabilities had a fair value of $30.7&amp;#xA0;million
 and $30.5&amp;#xA0;million, respectively.&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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 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
 was measured at fair value, it would be categorized as Level&amp;#xA0;2
 in the fair value hierarchy. The estimated fair value of the
 Company&amp;#x2019;s 5.25% senior unsecured notes due 2023 was
 $735.0&amp;#xA0;million and $763.1&amp;#xA0;million, at June&amp;#xA0;30, 2018
 and December&amp;#xA0;31, 2017, respectively, and was estimated using
 trading prices on such dates as Level&amp;#xA0;2 inputs to estimate
 fair value.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:FairValueDisclosuresTextBlock>
  <dei:DocumentPeriodEndDate contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_1B91FE88-9F1A-4FB4-A40D-8839F9133E50_1_2">2018-06-30</dei:DocumentPeriodEndDate>
  <us-gaap:EarningsPerShareBasic contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD_per_shares" decimals="2" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_3_16">1.54</us-gaap:EarningsPerShareBasic>
  <dei:EntityFilerCategory contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_3AF2A964-DF95-44FF-8F0D-AD08CF55B931_1_4">Large Accelerated Filer</dei:EntityFilerCategory>
  <us-gaap:GeneralAndAdministrativeExpense contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_3_4">216684000</us-gaap:GeneralAndAdministrativeExpense>
  <us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_3_12">197021000</us-gaap:IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest>
  <us-gaap:IncomeLossFromEquityMethodInvestments contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_3_10">2782000</us-gaap:IncomeLossFromEquityMethodInvestments>
  <us-gaap:IncomeTaxExpenseBenefit contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_3_13">54181000</us-gaap:IncomeTaxExpenseBenefit>
  <us-gaap:IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_1_15">-5863000</us-gaap:IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve>
  <us-gaap:IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_1_10">1178000</us-gaap:IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets>
  <us-gaap:HeldToMaturitySecuritiesTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_D7BFE1B0-8C86-45DE-922B-9198A8F55814_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Investments held at June&amp;#xA0;30, 2018 and December&amp;#xA0;31, 2017
 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="61%"&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="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="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;June&amp;#xA0;30, 2018&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, 2017&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;8,432&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;48,613&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;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;/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" 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;36,393&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;1,000&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;/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;1,470&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;5,180&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;4,165&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;9,902&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;90,186&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,292&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;/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:IncreaseDecreaseInAccountsPayableAndAccruedLiabilities contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_1_12">-100442000</us-gaap:IncreaseDecreaseInAccountsPayableAndAccruedLiabilities>
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  <us-gaap:IncreaseDecreaseInOtherNoncurrentAssets contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_1_11">317000</us-gaap:IncreaseDecreaseInOtherNoncurrentAssets>
  <us-gaap:IncreaseDecreaseInAccountsReceivable contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_1_9">23998000</us-gaap:IncreaseDecreaseInAccountsReceivable>
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  <us-gaap:InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_B2563AD0-5E06-4DE1-8C07-A79E4F52FAA2_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.&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="top" align="left"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 0pt" align="left"&gt;&lt;b&gt;Cash Equivalents and Investments:&lt;/b&gt;&lt;/p&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-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 As of June&amp;#xA0;30, 2018 and December&amp;#xA0;31, 2017, the
 Company&amp;#x2019;s cash equivalents consisted entirely of money market
 funds totaling $2.4&amp;#xA0;million and $9.2&amp;#xA0;million,
 respectively.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&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;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&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 and equity securities.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Investments held at June&amp;#xA0;30, 2018 and December&amp;#xA0;31, 2017
 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="61%"&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="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="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;June&amp;#xA0;30, 2018&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, 2017&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;8,432&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;48,613&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;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;/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" 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;36,393&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;1,000&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;/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;1,470&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;5,180&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;4,165&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;9,902&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;90,186&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;10,292&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;/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-LEFT: 4%; 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="68%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="10%"&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="10%"&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="2" align="center"&gt;&lt;b&gt;June&amp;#xA0;30,&amp;#xA0;2018&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;December&amp;#xA0;31,&amp;#xA0;2017&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;89,186&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;78,561&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;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;2,121&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;90,186&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;/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---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_3_8">2666000</us-gaap:InvestmentIncomeNet>
  <us-gaap:InvestmentsClassifiedByContractualMaturityDateTableTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_24053E2F-6BD2-45A8-903A-8C1B2DEB9807_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; 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="68%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="10%"&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="10%"&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="2" align="center"&gt;&lt;b&gt;June&amp;#xA0;30,&amp;#xA0;2018&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;December&amp;#xA0;31,&amp;#xA0;2017&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;89,186&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;78,561&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;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;2,121&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;90,186&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;/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:NewAccountingPronouncementsPolicyPolicyTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_28158357-7F03-4FEF-87D3-6BEDCA8629E4_1_0">&lt;div&gt;
 &lt;p style="margin-top:18pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman"&gt;
 &lt;b&gt;New Accounting Pronouncements&lt;/b&gt;&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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 has completed the review of its existing lease
 portfolio and is accumulating all of the necessary information
 required to properly account for leases under the new guidance. The
 Company has selected a software application, inclusive of a lease
 administration module and an accounting module, and has begun the
 implementation process. The Company is in the process of designing
 workflows, business processes and internal controls surrounding the
 lease accounting process in order to meet the reporting and
 disclosure requirements. The Company&amp;#x2019;s implementation and
 continued evaluation of this new guidance and its impacts are
 expected to continue through the third quarter of 2018.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:NewAccountingPronouncementsPolicyPolicyTextBlock>
  <us-gaap:NonoperatingIncomeExpense contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_3_11">-36091000</us-gaap:NonoperatingIncomeExpense>
  <us-gaap:OrganizationConsolidationBasisOfPresentationBusinessDescriptionAndAccountingPoliciesTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_5871C882-73F1-4708-BB48-EBE1999422EA_1_0">&lt;div&gt;
 &lt;table style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" border="0" cellpadding="0" cellspacing="0" width="100%"&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td width="4%" valign="top" align="left"&gt;&lt;b&gt;1.&lt;/b&gt;&lt;/td&gt;
 &lt;td align="left" valign="top"&gt;
 &lt;p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"&gt;&lt;b&gt;Basis of Presentation and New Accounting
 Pronouncements:&lt;/b&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 The accompanying unaudited Condensed Consolidated Financial
 Statements of the Company and the notes thereto presented in this
 &lt;font style="white-space:nowrap"&gt;Form&amp;#xA0;10-Q&lt;/font&gt; have been
 prepared in accordance with the rules and regulations of the
 Securities and Exchange Commission (&amp;#x201C;SEC&amp;#x201D;) applicable
 to interim financial statements, and do not include all disclosures
 required by accounting principles generally accepted in the United
 States of America (&amp;#x201C;GAAP&amp;#x201D;) for complete financial
 statements. In the opinion of management, these financial
 statements include all adjustments, consisting only of normal
 recurring adjustments, necessary for a fair statement of the
 results of interim periods. The financial statements include all
 the accounts of MEDNAX, Inc. and its consolidated subsidiaries
 (collectively, &amp;#x201C;MDX&amp;#x201D;) together with the accounts of
 MDX&amp;#x2019;s affiliated business corporations or professional
 associations, professional corporations, limited liability
 companies and partnerships (the &amp;#x201C;affiliated professional
 contractors&amp;#x201D;). Certain subsidiaries of MDX have contractual
 management arrangements with its affiliated professional
 contractors, which are separate legal entities that provide
 physician services in certain states and Puerto Rico. The terms
 &amp;#x201C;MEDNAX&amp;#x201D; and the &amp;#x201C;Company&amp;#x201D; refer
 collectively to MEDNAX, Inc., its subsidiaries and the affiliated
 professional contractors.&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 The Company is a party to a joint venture in which it owns a 37.5%
 economic interest. In January 2018, the Company entered into an
 additional joint venture in which it owns a 49.0% economic
 interest. The Company accounts for these joint ventures under the
 equity method of accounting because the Company exercises
 significant influence over, but does not control, these entities.
 See Note 5 for more information regarding the January 2018 joint
 venture.&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 The consolidated results of operations for the interim periods
 presented are not necessarily indicative of the results to be
 experienced for the entire fiscal year. In addition, the
 accompanying unaudited Condensed Consolidated Financial Statements
 and the notes thereto should be read in conjunction with the
 Consolidated Financial Statements and the notes thereto included in
 the Company&amp;#x2019;s most recent Annual Report on &lt;font style="white-space:nowrap"&gt;Form&amp;#xA0;10-K&lt;/font&gt; (the &amp;#x201C;Form
 &lt;font style="white-space:nowrap"&gt;10-K&amp;#x201D;).&lt;/font&gt;&lt;/p&gt;
 &lt;p style="margin-top:18pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman"&gt;
 &lt;b&gt;Recently Adopted Accounting Pronouncements&lt;/b&gt;&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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. The guidance became effective
 for the Company on January&amp;#xA0;1, 2018 and was adopted on a full
 retrospective basis. 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, 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 did not have
 an impact on our Consolidated Financial Statements, other than
 increased financial statement disclosures. The guidance requires
 increased disclosures, including qualitative and quantitative
 disclosures about the nature, amount, timing and uncertainty of
 revenue and cash flows arising from contracts with customers. See
 Note 4 for more information.&lt;/p&gt;
 &lt;p style="margin-top:18pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman"&gt;
 &lt;b&gt;New Accounting Pronouncements&lt;/b&gt;&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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 has completed the review of its existing lease
 portfolio and is accumulating all of the necessary information
 required to properly account for leases under the new guidance. The
 Company has selected a software application, inclusive of a lease
 administration module and an accounting module, and has begun the
 implementation process. The Company is in the process of designing
 workflows, business processes and internal controls surrounding the
 lease accounting process in order to meet the reporting and
 disclosure requirements. The Company&amp;#x2019;s implementation and
 continued evaluation of this new guidance and its impacts are
 expected to continue through the third quarter of 2018.&lt;/p&gt;
 &lt;/div&gt;</us-gaap:OrganizationConsolidationBasisOfPresentationBusinessDescriptionAndAccountingPoliciesTextBlock>
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  <us-gaap:ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_5BAE2791-320D-4A0E-8A8E-688D107DC051_1_0">&lt;div&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 Accounts payable and accrued expenses consist of the following (in
 thousands):&lt;/p&gt;
 &lt;p style="font-size:12pt;margin-top:0pt;margin-bottom:0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table cellspacing="0" cellpadding="0" width="76%" border="0" style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" align="center"&gt;
 &lt;tr&gt;
 &lt;td width="68%"&gt;&lt;/td&gt;
 &lt;td valign="bottom" width="9%"&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="9%"&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 ; font-family:Times New Roman; font-size:8pt"&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 valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"&gt;
 &lt;b&gt;June&amp;#xA0;30,&amp;#xA0;2018&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 valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"&gt;
 &lt;b&gt;December&amp;#xA0;31,&amp;#xA0;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Accounts payable&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;28,377&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;34,632&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Accrued salaries and bonuses&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;144,911&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;225,429&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Accrued payroll taxes 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;71,379&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;75,672&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Accrued professional liabilities&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;35,253&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;37,912&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Accrued contingent consideration&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;26,783&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;6,259&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Accrued interest&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;5,077&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;4,495&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Other accrued 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;46,475&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;53,618&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px 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 ; font-family:Times New Roman; font-size:10pt"&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;358,255&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;438,017&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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:ScheduleOfAccountsNotesLoansAndFinancingReceivableTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_C468F3E8-2A75-443D-902E-49FC94D1E376_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; 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="68%"&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="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: 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;June&amp;#xA0;30, 2018&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;December&amp;#xA0;31,&amp;#xA0;2017&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;1,918,787&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;1,790,034&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;(1,390,790&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;(1,286,035&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;527,997&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;503,999&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:ShareBasedCompensation contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_49B23481-302E-4B97-92BA-B0D9080DC0E2_1_5">20399000</us-gaap:ShareBasedCompensation>
  <us-gaap:ScheduleOfRevenueSourcesHealthCareOrganizationTableTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_D13619E2-0619-469C-B90D-84708412A4AF_1_0">&lt;div&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 0pt; TEXT-INDENT: 4%"&gt;
 The approximate percentage of net patient service revenue by type
 of payor was 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="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="72%"&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="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="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;Three&amp;#xA0;Months&amp;#xA0;Ended&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;June&amp;#xA0;30,&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="6" align="center"&gt;&lt;b&gt;Six&amp;#xA0;Months&amp;#xA0;Ended&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;June&amp;#xA0;30,&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;2018&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;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;2018&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;2017&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;
 Contracted managed care&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;70&lt;/td&gt;
 &lt;td valign="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;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;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;70&lt;/td&gt;
 &lt;td valign="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;71&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;
 Government&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&lt;/td&gt;
 &lt;td valign="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&lt;/td&gt;
 &lt;td valign="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&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&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;24&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;
 Other third-parties&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;4&lt;/td&gt;
 &lt;td valign="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;4&lt;/td&gt;
 &lt;td valign="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;4&lt;/td&gt;
 &lt;td valign="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;4&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;
 &lt;font style="WHITE-SPACE: nowrap"&gt;Private-pay&lt;/font&gt; patients&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&lt;/td&gt;
 &lt;td valign="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;1&lt;/td&gt;
 &lt;td valign="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;1&lt;/td&gt;
 &lt;td valign="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;1&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;/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;100&lt;/td&gt;
 &lt;td valign="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;100&lt;/td&gt;
 &lt;td valign="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;100&lt;/td&gt;
 &lt;td valign="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;100&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;/div&gt;</us-gaap:ScheduleOfRevenueSourcesHealthCareOrganizationTableTextBlock>
  <us-gaap:ScheduleOfWeightedAverageNumberOfSharesTableTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_0C123B75-F5CC-48EF-95BD-93D382258CAC_1_0">&lt;div&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 The calculation of shares used in the basic and diluted net income
 per common share calculation for the three and six months ended
 June&amp;#xA0;30, 2018 and 2017 is as follows (in thousands):&lt;/p&gt;
 &lt;p style="font-size:12pt;margin-top:0pt;margin-bottom:0pt"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;table cellspacing="0" cellpadding="0" width="92%" border="0" style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" align="center"&gt;
 &lt;tr&gt;
 &lt;td width="72%"&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="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt"&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 valign="bottom" colspan="6" align="center" style="border-bottom:1.00pt solid #000000"&gt;
 &lt;b&gt;Three&amp;#xA0;Months&amp;#xA0;Ended&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;June&amp;#xA0;30,&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 valign="bottom" colspan="6" align="center" style="border-bottom:1.00pt solid #000000"&gt;&lt;b&gt;Six Months Ended&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;June&amp;#xA0;30,&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt"&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 valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"&gt;&lt;b&gt;2018&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 valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"&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 valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"&gt;&lt;b&gt;2018&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 valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"&gt;&lt;b&gt;2017&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr bgcolor="#CCEEFF" style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Weighted average number of common shares outstanding&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;92,987&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;92,181&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;92,922&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;92,270&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;/tr&gt;
 &lt;tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Weighted average number of dilutive common share equivalents&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;542&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;631&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;594&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;707&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px 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 ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Weighted average number of common and common equivalent shares
 outstanding&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;93,529&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;92,812&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;93,516&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;92,977&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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 ; font-family:Times New Roman; font-size:10pt"&gt;
 &lt;td valign="top"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; margin-left:1.00em; text-indent:-1.00em; font-size:10pt; font-family:Times New Roman"&gt;
 Antidilutive securities not included in the diluted net income per
 common share calculation&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;392&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;197&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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;5&lt;/td&gt;
 &lt;td nowrap="nowrap" valign="bottom"&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-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;/td&gt;
 &lt;td valign="bottom"&gt;
 &lt;p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px 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>
  <dei:TradingSymbol contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_3AF2A964-DF95-44FF-8F0D-AD08CF55B931_1_0">MD</dei:TradingSymbol>
  <us-gaap:StockRepurchasedDuringPeriodValue contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-5" id="id_13580812_7011D69B-AF14-4DB3-B428-F25C231E223B_1_1">52200000</us-gaap:StockRepurchasedDuringPeriodValue>
  <us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="shares" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_3_20">93516000</us-gaap:WeightedAverageNumberOfDilutedSharesOutstanding>
  <us-gaap:WeightedAverageNumberOfSharesOutstandingBasic contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="shares" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_3_19">92922000</us-gaap:WeightedAverageNumberOfSharesOutstandingBasic>
  <md:PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-5" id="id_13580812_810D5C1C-3FAE-4E07-B97D-3F299C2FC43F_1_1">1200000</md:PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions>
  <md:PracticeSuppliesAndOtherOperatingExpenses contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_3_3">62488000</md:PracticeSuppliesAndOtherOperatingExpenses>
  <md:IncreaseDecreaseInAccruedPayrollTaxesAndBenefits contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-5" id="id_13580812_36ED23CE-FF29-432F-ADA2-E7373315FFDD_1_0">80500000</md:IncreaseDecreaseInAccruedPayrollTaxesAndBenefits>
  <md:PracticeSalariesAndBenefits contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="iso4217_USD" decimals="-3" id="id_13580812_2B1CBE96-8B30-404E-9033-1F2DC4E41A57_3_2">1252810000</md:PracticeSalariesAndBenefits>
  <md:NumberOfPhysicianGroupPracticesAcquired contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="Company" decimals="INF" id="id_13580812_62F7F805-008B-4A56-AEEC-3B28AB825059_1_0">5</md:NumberOfPhysicianGroupPracticesAcquired>
  <md:NumberOfPediatricSubspecialtyPracticesAcquired contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="Company" decimals="INF" id="id_13580812_62F7F805-008B-4A56-AEEC-3B28AB825059_1_2">2</md:NumberOfPediatricSubspecialtyPracticesAcquired>
  <md:NumberOfRadiologyPracticesAcquired contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="Company" decimals="INF" id="id_13580812_62F7F805-008B-4A56-AEEC-3B28AB825059_1_3">2</md:NumberOfRadiologyPracticesAcquired>
  <md:NumberOfNeonatologyPracticesAcquired contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" unitRef="Company" decimals="INF" id="id_13580812_62F7F805-008B-4A56-AEEC-3B28AB825059_1_1">1</md:NumberOfNeonatologyPracticesAcquired>
  <md:AccountsReceivableAndNetRevenueDisclosureTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_38EFEBA5-ACD7-4E3B-A1C4-00D6242218A7_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;4.&lt;/b&gt;&lt;/td&gt;
 &lt;td valign="top" align="left"&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 0pt" align="left"&gt;&lt;b&gt;Accounts Receivable and Net Revenue:&lt;/b&gt;&lt;/p&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-LEFT: 4%; 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="68%"&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="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: 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;June&amp;#xA0;30, 2018&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;December&amp;#xA0;31,&amp;#xA0;2017&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;1,918,787&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;1,790,034&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;(1,390,790&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;(1,286,035&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;527,997&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;503,999&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-LEFT: 4%; MARGIN-TOP: 12pt; TEXT-INDENT: 4%"&gt;
 Patient service revenue is recognized at the time services are
 provided by the Company&amp;#x2019;s affiliated physicians. The
 Company&amp;#x2019;s performance obligations related to the delivery of
 services to patients are satisfied at the time of service.
 Accordingly, there are no performance obligations that are
 unsatisfied or partially unsatisfied at the end of the reporting
 period with respect to patient service revenue. 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;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&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 third-party insurance payors for such services.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Collection of patient service revenue the Company expects to
 receive is normally a function of providing complete and correct
 billing information to the government-sponsored healthcare programs
 and third-party insurance payors within the various filing
 deadlines and typically occurs
 within&amp;#xA0;30&amp;#xA0;to&amp;#xA0;60&amp;#xA0;days of billing.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 Some of the Company&amp;#x2019;s hospital agreements require hospitals
 to pay the Company administrative fees. Some agreements provide for
 fees if the hospital does not generate sufficient patient volume in
 order to guarantee that the Company receives a specified minimum
 revenue level. The Company also receives fees from hospitals for
 administrative services performed by its affiliated physicians
 providing medical director or other services at the hospital.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 In addition, the Company generates revenue through its management
 services organization 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.&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"&gt;
 The following table summarizes the Company&amp;#x2019;s net revenue by
 category (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="60%"&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;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;&amp;#xA0;&lt;/td&gt;
 &lt;td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"&gt;&lt;b&gt;Three Months Ended&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;June&amp;#xA0;30,&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;Six Months Ended&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;June&amp;#xA0;30,&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;2018&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;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;2018&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;2017&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 patient service 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;763,667&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;708,739&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,520,040&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&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;1,414,192&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&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;
 Hospital contract administrative fees&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;95,534&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;75,604&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;186,773&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;147,869&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;
 Management services and other&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;56,717&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;58,601&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;110,962&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;116,480&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;915,918&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;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;842,944&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&gt;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;&amp;#xA0;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom"&gt;$&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;1,817,775&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;1,678,541&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: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px"&gt;
 &amp;#xA0;&lt;/p&gt;
 &lt;p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 0pt; TEXT-INDENT: 4%"&gt;
 The approximate percentage of net patient service revenue by type
 of payor was 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="92%" align="center" border="0"&gt;
 &lt;tr&gt;
 &lt;td width="72%"&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="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="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;Three&amp;#xA0;Months&amp;#xA0;Ended&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;June&amp;#xA0;30,&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="6" align="center"&gt;&lt;b&gt;Six&amp;#xA0;Months&amp;#xA0;Ended&lt;/b&gt;&lt;br /&gt;
 &lt;b&gt;June&amp;#xA0;30,&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;2018&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;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;2018&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;2017&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;
 Contracted managed care&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;70&lt;/td&gt;
 &lt;td valign="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;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;&amp;#xA0;&lt;/td&gt;
 &lt;td valign="bottom" align="right"&gt;70&lt;/td&gt;
 &lt;td valign="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;71&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;
 Government&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&lt;/td&gt;
 &lt;td valign="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&lt;/td&gt;
 &lt;td valign="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&lt;/td&gt;
 &lt;td valign="bottom" nowrap="nowrap"&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;24&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;
 Other third-parties&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;4&lt;/td&gt;
 &lt;td valign="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;4&lt;/td&gt;
 &lt;td valign="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;4&lt;/td&gt;
 &lt;td valign="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;4&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;
 &lt;font style="WHITE-SPACE: nowrap"&gt;Private-pay&lt;/font&gt; patients&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&lt;/td&gt;
 &lt;td valign="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;1&lt;/td&gt;
 &lt;td valign="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;1&lt;/td&gt;
 &lt;td valign="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;1&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;/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;100&lt;/td&gt;
 &lt;td valign="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;100&lt;/td&gt;
 &lt;td valign="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;100&lt;/td&gt;
 &lt;td valign="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;100&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;/div&gt;</md:AccountsReceivableAndNetRevenueDisclosureTextBlock>
  <md:CommonStockRepurchasesTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_6F2D9C10-AA5A-482C-9CD0-110195A5FD39_1_0">&lt;div&gt;
 &lt;table style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" border="0" cellpadding="0" cellspacing="0" width="100%"&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td width="4%" valign="top" align="left"&gt;&lt;b&gt;9.&lt;/b&gt;&lt;/td&gt;
 &lt;td align="left" valign="top"&gt;
 &lt;p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"&gt;&lt;b&gt;Common Stock Repurchase Program:&lt;/b&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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. During the six months ended June&amp;#xA0;30,
 2018, the Company repurchased 1.2&amp;#xA0;million shares of its common
 stock for $52.2&amp;#xA0;million, inclusive of 54,909 shares withheld
 to satisfy minimum statutory withholding obligations of
 $2.5&amp;#xA0;million in connection with the vesting of restricted
 stock and stock option exercises during the three months ended
 June&amp;#xA0;30, 2018. The shares repurchased by the Company during
 the second quarter of 2018 completed the repurchases under the
 program with respect to issuances of shares under the
 Company&amp;#x2019;s equity compensation programs during 2018. 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;/p&gt;
 &lt;/div&gt;</md:CommonStockRepurchasesTextBlock>
  <md:RecentlyAdoptedAccountingPronouncementsPolicyTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_43318685-8E1D-4805-B09A-38584A17799C_1_0">&lt;div&gt;
 &lt;p style="margin-top:18pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman"&gt;
 &lt;b&gt;Recently Adopted Accounting Pronouncements&lt;/b&gt;&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&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. The guidance became effective
 for the Company on January&amp;#xA0;1, 2018 and was adopted on a full
 retrospective basis. 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, 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 did not have
 an impact on our Consolidated Financial Statements, other than
 increased financial statement disclosures. The guidance requires
 increased disclosures, including qualitative and quantitative
 disclosures about the nature, amount, timing and uncertainty of
 revenue and cash flows arising from contracts with customers. See
 Note 4 for more information.&lt;/p&gt;
 &lt;/div&gt;</md:RecentlyAdoptedAccountingPronouncementsPolicyTextBlock>
  <md:BusinessAcquisitionsJointVenturesAndGoodwillTextBlock contextRef="eol_PE10840---1810-Q0008_STD_181_20180630_0" id="id_13580812_4F40B9BD-BF16-4929-9987-760735B02D56_1_0">&lt;div&gt;
 &lt;table style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" border="0" cellpadding="0" cellspacing="0" width="100%"&gt;
 &lt;tr style="page-break-inside:avoid"&gt;
 &lt;td width="4%" valign="top" align="left"&gt;&lt;b&gt;5.&lt;/b&gt;&lt;/td&gt;
 &lt;td align="left" valign="top"&gt;
 &lt;p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"&gt;&lt;b&gt;Business Acquisitions, Joint Ventures and
 Goodwill:&lt;/b&gt;&lt;/p&gt;
 &lt;/td&gt;
 &lt;/tr&gt;
 &lt;/table&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 During the six months ended June&amp;#xA0;30, 2018, the Company
 completed the acquisition of five physician group practices,
 including two radiology practices, one neonatology practice and two
 pediatric subspecialty practices. The acquisition-date fair value
 of the total consideration for the five acquisitions was
 $24.4&amp;#xA0;million. These acquisitions expanded the Company&amp;#x2019;s
 national network of physician practices. In connection with these
 acquisitions, the Company recorded goodwill of $15.5&amp;#xA0;million
 and other intangible assets consisting primarily of physician and
 hospital agreements of $8.9 million.&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 In addition, during the six months ended June&amp;#xA0;30, 2018, in
 connection with certain prior-period acquisitions, the Company paid
 $0.4&amp;#xA0;million for contingent consideration and
 $1.2&amp;#xA0;million for purchase consideration that had been held
 back pending satisfaction of certain conditions. All amounts except
 for the accretion recorded during 2018 were accrued as of
 December&amp;#xA0;31, 2017.&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 In connection with certain prior-period acquisitions, the Company
 also recorded a decrease in current assets of $1.2&amp;#xA0;million, a
 decrease in noncurrent assets of $1.5&amp;#xA0;million, an increase in
 current liabilities of $1.4&amp;#xA0;million and an increase in
 noncurrent liabilities of $1.2&amp;#xA0;million, with a corresponding
 net increase in goodwill of $5.3&amp;#xA0;million for
 measurement-period adjustments resulting from the finalization of
 acquisition accounting. The Company expects that $18.2&amp;#xA0;million
 of the goodwill recorded during the six months ended June&amp;#xA0;30,
 2018 will be deductible for tax purposes.&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 In January 2018, the Company completed the sale of a controlling
 interest and the contribution of remaining assets to a joint
 venture related to the $46.0&amp;#xA0;million of assets held for sale
 at December&amp;#xA0;31, 2017. The Company accounts for its 49.0%
 economic interest in the joint venture as an equity method
 investment. The investment in this joint venture is included in
 other assets as presented in the Company&amp;#x2019;s Condensed
 Consolidated Balance Sheet.&lt;/p&gt;
 &lt;p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman"&gt;
 The Company&amp;#x2019;s management services reporting unit has
 experienced lower operating results than previously forecasted
 primarily due to a slower rate of new customer bookings and an
 increase in customer termination activity. The Company continues to
 believe that the fair value of the reporting unit exceeds the
 carrying value, and accordingly the goodwill assigned to the
 management services reporting unit is not impaired&amp;#xA0;Although
 the Company believes that the current assumptions and estimates
 used in its goodwill analysis are reasonable, supportable and
 appropriate, continued efforts to maintain or improve the
 performance of this business could be impacted by unfavorable or
 unforeseen changes which could impact the existing assumptions used
 in the impairment analysis. Various factors could reasonably be
 expected to unfavorably impact existing assumptions, primarily
 delays in new customer bookings and the related delay in revenue
 from new customers, increases in customer termination activity or
 increases in operating costs. Accordingly, there can be no
 assurance that the estimates and assumptions made for the purposes
 of the goodwill impairment analysis will prove to be accurate
 predictions of future performance. The carrying value of the
 Company&amp;#x2019;s management services reporting unit included
 goodwill of $321.6&amp;#xA0;million as of June&amp;#xA0;30, 2018. The
 Company will continue to closely monitor the performance of the
 management services reporting unit. If an impairment loss is
 required in a future period, it 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 the
 Company&amp;#x2019;s securities.&lt;/p&gt;
 &lt;/div&gt;</md:BusinessAcquisitionsJointVenturesAndGoodwillTextBlock>
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  <element name="NumberOfRadiologyPracticesAcquired" id="md_NumberOfRadiologyPracticesAcquired" type="xbrli:integerItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions" id="md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions" type="xbrli:monetaryItemType" abstract="false" xbrli:periodType="duration" xbrli:balance="credit" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="PercentageOfNetPatientServiceRevenueByTypeOfPayor" id="md_PercentageOfNetPatientServiceRevenueByTypeOfPayor" type="num:percentItemType" abstract="false" 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="RecentlyAdoptedAccountingPronouncementsPolicyTextBlock" id="md_RecentlyAdoptedAccountingPronouncementsPolicyTextBlock" type="nonnum:textBlockItemType" abstract="false" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="ScheduleOfCashCashEquivalentsAndInvestmentsTable" id="md_ScheduleOfCashCashEquivalentsAndInvestmentsTable" type="xbrli:stringItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrldt:hypercubeItem"/>
  <element name="ScheduleOfFinancingReceivablesLineItems" id="md_ScheduleOfFinancingReceivablesLineItems" type="xbrli:stringItemType" abstract="true" 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="TwoThousandFifteenNonQualifiedStockPurchasePlanMember" id="md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
  <element name="UnnamedCorporateJointVentureMember" id="md_UnnamedCorporateJointVentureMember" type="nonnum:domainItemType" abstract="true" xbrli:periodType="duration" nillable="true" substitutionGroup="xbrli:item"/>
</schema>
</XBRL>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.CAL
<SEQUENCE>7
<FILENAME>md-20180630_cal.xml
<DESCRIPTION>XBRL TAXONOMY EXTENSION CALCULATION LINKBASE
<TEXT>
<XBRL>
<?xml version="1.0" encoding="US-ASCII"?>
<!-- DFS Xcelerate Taxonomy Calculation Linkbase - http://www.dfsco.com/financial-services/ -->
<!-- Version: 6.23.6 -->
<!-- Round: 5 -->
<!-- Creation date: 2018-08-02T13:15:49Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
<linkbase xmlns="http://www.xbrl.org/2003/linkbase"
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  </calculationLink>
  <calculationLink xlink:type="extended" xlink:role="http://www.mednax.com/taxonomy/role/StatementOfFinancialPositionClassified">
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<DOCUMENT>
<TYPE>EX-101.DEF
<SEQUENCE>8
<FILENAME>md-20180630_def.xml
<DESCRIPTION>XBRL TAXONOMY EXTENSION DEFINITION LINKBASE
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<!-- DFS Xcelerate Taxonomy Definition Linkbase - http://www.dfsco.com/financial-services/ -->
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<!-- Round: 5 -->
<!-- Creation date: 2018-08-02T13:15:49Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
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</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.LAB
<SEQUENCE>9
<FILENAME>md-20180630_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: 2018-08-02T13:15:49Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AccountsReceivableAndNetRevenueDisclosureTextBlock_lbl" xml:lang="en-US" id="id_13580812_3340770_3_1">Accounts receivable and net revenue disclosure.</label>
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    <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_13580812_3063974_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_13580812_3063974_2_1">Gross accounts receivable</label>
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    <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_13580812_3063760_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_13580812_3063760_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_13580812_3063760_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-20180630.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_13580812_3188883_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_13580812_3188883_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_13580812_3188883_2_1">Accrued contingent consideration</label>
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    <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_13580812_3063557_1_1">Accrued Income Taxes, Current</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AccruedPayrollTaxesAndBenefitsCurrent_lbl" xml:lang="en-US" id="id_13580812_3186005_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_13580812_3186005_1_1">Accrued Payroll Taxes And Benefits Current</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3064004_1_1">Accrued Salaries, Current</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3063808_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_13580812_3063808_2_1">Additional paid-in capital</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3063597_1_1">Adjustments Related to Tax Withholding for Share-based Compensation</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3064049_1_1">Adjustments to Reconcile Net Income (Loss) to Cash Provided by (Used in) Operating Activities [Abstract]</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3063435_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_13580812_3063435_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_AllocatedShareBasedCompensationExpense" xlink:to="us-gaap_AllocatedShareBasedCompensationExpense_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3063636_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_13580812_3063636_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-20180630.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_13580812_3258165_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_13580812_3258165_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_13580812_3258165_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="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.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_13580812_3063668_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_13580812_3063668_2_1">Amendment Flag</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_AmendmentFlag" xlink:to="dei_AmendmentFlag_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AmortizationOfFinancingCostsAndDiscounts" xlink:label="us-gaap_AmortizationOfFinancingCostsAndDiscounts"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_AmortizationOfFinancingCostsAndDiscounts_lbl" xml:lang="en-US" id="id_13580812_3063876_1_1">Amortization of Debt Issuance Costs and Discounts</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AmortizationOfFinancingCostsAndDiscounts_lbl" xml:lang="en-US" id="id_13580812_3063876_2_1">Amortization of premiums, discounts and issuance costs</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_AmortizationOfFinancingCostsAndDiscounts" xlink:to="us-gaap_AmortizationOfFinancingCostsAndDiscounts_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20180630.xsd#md_AmortizedCostAndFairValueDebtSecuritiesAbstract" xlink:label="md_AmortizedCostAndFairValueDebtSecuritiesAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_AmortizedCostAndFairValueDebtSecuritiesAbstract_lbl" xml:lang="en-US" id="id_13580812_3087104_3_1">Amortized Cost and Fair Value Debt Securities [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_AmortizedCostAndFairValueDebtSecuritiesAbstract_lbl" xml:lang="en-US" id="id_13580812_3087104_1_1">Amortized Cost and Fair Value Debt Securities [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_AmortizedCostAndFairValueDebtSecuritiesAbstract_lbl" xml:lang="en-US" id="id_13580812_3087104_2_1">Amortized Cost and Fair Value Debt Securities [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_AmortizedCostAndFairValueDebtSecuritiesAbstract" xlink:to="md_AmortizedCostAndFairValueDebtSecuritiesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3063481_1_1">Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount_lbl" xml:lang="en-US" id="id_13580812_3063481_2_1">Antidilutive securities not included in the diluted net income per common share calculation</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3064141_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_13580812_3064141_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/2018/elts/us-gaap-2018-01-31.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_13580812_3063501_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_13580812_3063501_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/2018/elts/us-gaap-2018-01-31.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_13580812_3063503_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_13580812_3063503_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/2018/elts/us-gaap-2018-01-31.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_13580812_3064144_1_1">Assets, Current [Abstract]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_CashEquivalentsAndInvestmentsLineItems_lbl" xml:lang="en-US" id="id_13580812_3085734_3_1">Cash equivalents and investments.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_CashEquivalentsAndInvestmentsLineItems_lbl" xml:lang="en-US" id="id_13580812_3085734_1_1">Cash Equivalents And Investments [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_CashEquivalentsAndInvestmentsLineItems_lbl" xml:lang="en-US" id="id_13580812_3085734_2_1">Cash Equivalents And Investments [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_CashEquivalentsAndInvestmentsLineItems" xlink:to="md_CashEquivalentsAndInvestmentsLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashEquivalentsMember" xlink:label="us-gaap_CashEquivalentsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashEquivalentsMember_lbl" xml:lang="en-US" id="id_13580812_3065297_1_1">Cash Equivalents [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashEquivalentsMember_lbl" xml:lang="en-US" id="id_13580812_3065297_2_1">Cash Equivalents [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashEquivalentsMember" xlink:to="us-gaap_CashEquivalentsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashSurrenderValueOfLifeInsurance" xlink:label="us-gaap_CashSurrenderValueOfLifeInsurance"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_CashSurrenderValueOfLifeInsurance_lbl" xml:lang="en-US" id="id_13580812_3065102_1_1">Cash Surrender Value of Life Insurance</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_CashSurrenderValueOfLifeInsurance_lbl" xml:lang="en-US" id="id_13580812_3065102_2_1">Carrying amount of cash surrender value of life insurance</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_CashSurrenderValueOfLifeInsurance" xlink:to="us-gaap_CashSurrenderValueOfLifeInsurance_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3065535_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_13580812_3065535_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="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3065406_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_13580812_3065406_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/2018/elts/us-gaap-2018-01-31.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_13580812_3065589_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_13580812_3065589_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/2018/elts/us-gaap-2018-01-31.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_13580812_3065193_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_13580812_3065193_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/2018/elts/us-gaap-2018-01-31.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_13580812_3065599_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_13580812_3065599_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-20180630.xsd#md_CommonStockLineItems" xlink:label="md_CommonStockLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_CommonStockLineItems_lbl" xml:lang="en-US" id="id_13580812_3091252_3_1">Common Stock [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_CommonStockLineItems_lbl" xml:lang="en-US" id="id_13580812_3091252_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_13580812_3091252_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/2018/elts/us-gaap-2018-01-31.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_13580812_3065602_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_13580812_3065602_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/2018/elts/us-gaap-2018-01-31.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_13580812_3065857_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_13580812_3065857_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-20180630.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_13580812_3348135_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_13580812_3348135_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_13580812_3348135_2_1">Common Stock Repurchase Program</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="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3065416_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_13580812_3065416_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_13580812_3065416_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/2018/elts/us-gaap-2018-01-31.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_13580812_3065859_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_13580812_3065859_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/2018/elts/us-gaap-2018-01-31.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_13580812_3065417_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_13580812_3065417_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-20180630.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_13580812_3239015_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_13580812_3239015_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_13580812_3239015_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/2018/elts/us-gaap-2018-01-31.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_13580812_3065862_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_13580812_3065862_2_1">Common stock; $.01 par value; 200,000 shares authorized; 93,374 and 93,721 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="md-20180630.xsd#md_ContractedManagedCareMember" xlink:label="md_ContractedManagedCareMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ContractedManagedCareMember_lbl" xml:lang="en-US" id="id_13580812_3281104_3_1">Contracted Managed Care [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ContractedManagedCareMember_lbl" xml:lang="en-US" id="id_13580812_3281104_1_1">Contracted Managed Care [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ContractedManagedCareMember_lbl" xml:lang="en-US" id="id_13580812_3281104_2_1">Contracted Managed Care [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ContractedManagedCareMember" xlink:to="md_ContractedManagedCareMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3066013_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_13580812_3066013_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/2018/elts/us-gaap-2018-01-31.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_13580812_3066014_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_13580812_3066014_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="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.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_13580812_3066670_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_13580812_3066670_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/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentInterestRateStatedPercentage" xlink:label="us-gaap_DebtInstrumentInterestRateStatedPercentage"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FairValueDisclosuresAbstract_lbl" xml:lang="en-US" id="id_13580812_3068699_1_1">Fair Value Disclosures [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FairValueDisclosuresAbstract_lbl" xml:lang="en-US" id="id_13580812_3068699_2_1">Fair Value Disclosures [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="us-gaap_FairValueDisclosuresAbstract_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FairValueDisclosuresTextBlock_lbl" xml:lang="en-US" id="id_13580812_3069115_1_1">Fair Value Disclosures [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_FairValueDisclosuresTextBlock_lbl" xml:lang="en-US" id="id_13580812_3069115_2_1">Fair Value Measurements</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_FairValueDisclosuresTextBlock" xlink:to="us-gaap_FairValueDisclosuresTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20180630.xsd#md_FairValueMeasurementsDisclosureLineItems" xlink:label="md_FairValueMeasurementsDisclosureLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_FairValueMeasurementsDisclosureLineItems_lbl" xml:lang="en-US" id="id_13580812_3086353_3_1">Fair Value Measurements Disclosure [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_FairValueMeasurementsDisclosureLineItems_lbl" xml:lang="en-US" id="id_13580812_3086353_1_1">Fair Value Measurements Disclosure [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_FairValueMeasurementsDisclosureLineItems_lbl" xml:lang="en-US" id="id_13580812_3086353_2_1">Fair Value Measurements Disclosure [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_FairValueMeasurementsDisclosureLineItems" xlink:to="md_FairValueMeasurementsDisclosureLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20180630.xsd#md_FairValueMeasurementsDisclosureTable" xlink:label="md_FairValueMeasurementsDisclosureTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_FairValueMeasurementsDisclosureTable_lbl" xml:lang="en-US" id="id_13580812_3238296_3_1">Fair Value Measurements Disclosure [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_FairValueMeasurementsDisclosureTable_lbl" xml:lang="en-US" id="id_13580812_3238296_1_1">Fair Value Measurements Disclosure [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_FairValueMeasurementsDisclosureTable_lbl" xml:lang="en-US" id="id_13580812_3238296_2_1">Fair Value Measurements Disclosure [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_FairValueMeasurementsDisclosureTable" xlink:to="md_FairValueMeasurementsDisclosureTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsNet" xlink:label="us-gaap_FiniteLivedIntangibleAssetsNet"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_FiniteLivedIntangibleAssetsNet_lbl" xml:lang="en-US" id="id_13580812_3070675_1_1">Finite-Lived Intangible Assets, Net</label>
    <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_13580812_3070675_2_1">Intangible assets, net</label>
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    <loc xlink:type="locator" xlink:href="md-20180630.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_13580812_3297729_3_1">Five point two five percent senior unsecured notes due two thousand twenty three.</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3071073_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_13580812_3071073_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/2018/elts/us-gaap-2018-01-31.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_13580812_3070822_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_13580812_3070822_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/2018/elts/us-gaap-2018-01-31.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_13580812_3071749_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_13580812_3071749_2_1">Net 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/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GovernmentMember" xlink:label="us-gaap_GovernmentMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_GovernmentMember_lbl" xml:lang="en-US" id="id_13580812_3071755_1_1">Government [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_GovernmentMember_lbl" xml:lang="en-US" id="id_13580812_3071755_2_1">Government [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_GovernmentMember" xlink:to="us-gaap_GovernmentMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HealthCareMember" xlink:label="us-gaap_HealthCareMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HealthCareMember_lbl" xml:lang="en-US" id="id_13580812_3071341_1_1">Health Care [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HealthCareMember_lbl" xml:lang="en-US" id="id_13580812_3071341_2_1">Health Care</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HealthCareMember" xlink:to="us-gaap_HealthCareMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems" xlink:label="us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems_lbl" xml:lang="en-US" id="id_13580812_3071785_1_1">Health Care Organization, Receivable and Revenue Disclosures [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems_lbl" xml:lang="en-US" id="id_13580812_3071785_2_1">Health Care Organization, Receivable and Revenue Disclosures [Line Items]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems" xlink:to="us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HealthCareOrganizationRevenueAndExpenseAbstract" xlink:label="us-gaap_HealthCareOrganizationRevenueAndExpenseAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HealthCareOrganizationRevenueAndExpenseAbstract_lbl" xml:lang="en-US" id="id_13580812_3071346_1_1">Health Care Organization Revenue and Expense [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HealthCareOrganizationRevenueAndExpenseAbstract_lbl" xml:lang="en-US" id="id_13580812_3071346_2_1">Health Care Organization Revenue and Expense [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HealthCareOrganizationRevenueAndExpenseAbstract" xlink:to="us-gaap_HealthCareOrganizationRevenueAndExpenseAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HealthCareOrganizationRevenueSourcesAxis" xlink:label="us-gaap_HealthCareOrganizationRevenueSourcesAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HealthCareOrganizationRevenueSourcesAxis_lbl" xml:lang="en-US" id="id_13580812_3071347_1_1">Health Care Organization, Revenue Sources [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HealthCareOrganizationRevenueSourcesAxis_lbl" xml:lang="en-US" id="id_13580812_3071347_2_1">Health Care Organization, Revenue Sources [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesAxis" xlink:to="us-gaap_HealthCareOrganizationRevenueSourcesAxis_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HealthCareOrganizationRevenueSourcesDomain_lbl" xml:lang="en-US" id="id_13580812_3071348_1_1">Health Care Organization, Revenue Sources [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HealthCareOrganizationRevenueSourcesDomain_lbl" xml:lang="en-US" id="id_13580812_3071348_2_1">Health Care Organization, Revenue Sources [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HealthCareOrganizationRevenueSourcesDomain" xlink:to="us-gaap_HealthCareOrganizationRevenueSourcesDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_HealthCarePatientServiceMember" xlink:label="us-gaap_HealthCarePatientServiceMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_HealthCarePatientServiceMember_lbl" xml:lang="en-US" id="id_13580812_3071532_1_1">Health Care, Patient Service [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HealthCarePatientServiceMember_lbl" xml:lang="en-US" id="id_13580812_3071532_2_1">Net patient service revenue</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_HealthCarePatientServiceMember" xlink:to="us-gaap_HealthCarePatientServiceMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3071542_1_1">Debt Securities, Held-to-maturity, 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_13580812_3071542_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_13580812_3071542_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/2018/elts/us-gaap-2018-01-31.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_13580812_3071544_1_1">Debt Securities, Held-to-maturity, Maturity, Allocated and Single Maturity Date, after Five Through Ten Years, Amortized Cost</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_13580812_3071544_2_1">Due after five years through [six] years</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3071813_1_1">Debt Securities, Held-to-maturity, Maturity, Allocated and Single Maturity Date, after One Through Five Years, Amortized Cost</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount_lbl" xml:lang="en-US" id="id_13580812_3071813_2_1">Due after one year through five years</label>
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    <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_13580812_3072894_1_1">Liabilities, Current</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3073422_1_1">Liabilities, Current [Abstract]</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3074330_1_1">Malpractice Loss Contingency, Accrual, Undiscounted, Current</label>
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    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent" xlink:to="us-gaap_MalpracticeLossContingencyAccrualUndiscountedCurrent_lbl"/>
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    <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_13580812_3075225_1_1">Malpractice Loss Contingency, Accrual, Undiscounted, Noncurrent</label>
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    <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/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ManagementServiceMember" xlink:label="us-gaap_ManagementServiceMember"/>
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    <loc xlink:type="locator" xlink:href="md-20180630.xsd#md_ManagementServicesReportingUnitMember" xlink:label="md_ManagementServicesReportingUnitMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ManagementServicesReportingUnitMember_lbl" xml:lang="en-US" id="id_13580812_3281103_3_1">Management Services Reporting Unit [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_ManagementServicesReportingUnitMember_lbl" xml:lang="en-US" id="id_13580812_3281103_1_1">Management Services Reporting Unit [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ManagementServicesReportingUnitMember_lbl" xml:lang="en-US" id="id_13580812_3281103_2_1">Management Services Reporting Unit [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_ManagementServicesReportingUnitMember" xlink:to="md_ManagementServicesReportingUnitMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:label="srt_MaximumMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="srt_MaximumMember_lbl" xml:lang="en-US" id="id_13580812_3074821_1_1">Maximum [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="srt_MaximumMember_lbl" xml:lang="en-US" id="id_13580812_3074821_2_1">Maximum [Member]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="srt_MinimumMember_lbl" xml:lang="en-US" id="id_13580812_3075282_1_1">Minimum [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="srt_MinimumMember_lbl" xml:lang="en-US" id="id_13580812_3075282_2_1">Minimum [Member]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_MoneyMarketFundsAtCarryingValue_lbl" xml:lang="en-US" id="id_13580812_3075296_1_1">Money Market Funds, at Carrying Value</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_MoneyMarketFundsAtCarryingValue_lbl" xml:lang="en-US" id="id_13580812_3075296_2_1">Cash equivalents</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivities_lbl" xml:lang="en-US" id="id_13580812_3075138_1_1">Net Cash Provided by (Used in) Financing Activities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivities_lbl" xml:lang="en-US" id="id_13580812_3075138_6_1">Net cash (used in) provided from financing activities</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract_lbl" xml:lang="en-US" id="id_13580812_3075384_1_1">Net Cash Provided by (Used in) Financing Activities [Abstract]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivities_lbl" xml:lang="en-US" id="id_13580812_3074968_1_1">Net Cash Provided by (Used in) Investing Activities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivities_lbl" xml:lang="en-US" id="id_13580812_3074968_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_NetCashProvidedByUsedInInvestingActivities" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract_lbl" xml:lang="en-US" id="id_13580812_3075386_1_1">Net Cash Provided by (Used in) Investing Activities [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract_lbl" xml:lang="en-US" id="id_13580812_3075386_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_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivities"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivities_lbl" xml:lang="en-US" id="id_13580812_3075387_1_1">Net Cash Provided by (Used in) Operating Activities</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivities_lbl" xml:lang="en-US" id="id_13580812_3075387_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_NetCashProvidedByUsedInOperatingActivities" xlink:to="us-gaap_NetCashProvidedByUsedInOperatingActivities_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract_lbl" xml:lang="en-US" id="id_13580812_3074970_1_1">Net 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_NetCashProvidedByUsedInOperatingActivitiesAbstract_lbl" xml:lang="en-US" id="id_13580812_3074970_2_1">Cash flows from operating activities:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3074638_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_13580812_3074638_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-20180630.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_13580812_3384934_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_13580812_3384934_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_13580812_3384934_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-20180630.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_13580812_3271447_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_13580812_3271447_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_13580812_3271447_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/2018/elts/us-gaap-2018-01-31.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_13580812_3074676_1_1">Nonoperating Income (Expense)</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_13580812_3074676_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/2018/elts/us-gaap-2018-01-31.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_13580812_3074689_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_13580812_3074689_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-20180630.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_13580812_3220492_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_13580812_3220492_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_13580812_3220492_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-20180630.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_13580812_3219413_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_13580812_3219413_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_13580812_3219413_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-20180630.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_13580812_3216353_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_13580812_3216353_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_13580812_3216353_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-20180630.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_13580812_3219558_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_13580812_3219558_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_13580812_3219558_2_1">Number of radiology practices acquired</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_NumberOfRadiologyPracticesAcquired" xlink:to="md_NumberOfRadiologyPracticesAcquired_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3075924_1_1">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_13580812_3075924_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/2018/elts/us-gaap-2018-01-31.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_13580812_3075761_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_13580812_3075761_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/2018/elts/us-gaap-2018-01-31.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_13580812_3076165_1_1">Operating Income (Loss)</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_13580812_3076165_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/2018/elts/us-gaap-2018-01-31.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_13580812_3075797_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_13580812_3075797_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/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OrganizationConsolidationBasisOfPresentationBusinessDescriptionAndAccountingPoliciesTextBlock" xlink:label="us-gaap_OrganizationConsolidationBasisOfPresentationBusinessDescriptionAndAccountingPoliciesTextBlock"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_OrganizationConsolidationBasisOfPresentationBusinessDescriptionAndAccountingPoliciesTextBlock_lbl" xml:lang="en-US" id="id_13580812_3074766_1_1">Organization, Consolidation, Basis of Presentation, Business Description and Accounting Policies [Text Block]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_OrganizationConsolidationBasisOfPresentationBusinessDescriptionAndAccountingPoliciesTextBlock_lbl" xml:lang="en-US" id="id_13580812_3074766_2_1">Basis of Presentation and New Accounting Pronouncements</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_OrganizationConsolidationBasisOfPresentationBusinessDescriptionAndAccountingPoliciesTextBlock" xlink:to="us-gaap_OrganizationConsolidationBasisOfPresentationBusinessDescriptionAndAccountingPoliciesTextBlock_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3075431_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_13580812_3075431_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/2018/elts/us-gaap-2018-01-31.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_13580812_3075435_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_13580812_3075435_2_1">Other current 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/2018/elts/us-gaap-2018-01-31.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_13580812_3075961_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_13580812_3075961_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/2018/elts/us-gaap-2018-01-31.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_13580812_3076709_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_13580812_3076709_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/2018/elts/us-gaap-2018-01-31.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_13580812_3075545_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_13580812_3075545_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/2018/elts/us-gaap-2018-01-31.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_13580812_3076645_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_13580812_3076645_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/2018/elts/us-gaap-2018-01-31.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_13580812_3077032_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_13580812_3077032_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/2018/elts/us-gaap-2018-01-31.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_13580812_3077033_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_13580812_3077033_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="md-20180630.xsd#md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions" xlink:label="md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions_lbl" xml:lang="en-US" id="id_13580812_3117671_3_1">Payment For Purchase Consideration Related To Prior Period Acquisitions</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions_lbl" xml:lang="en-US" id="id_13580812_3117671_1_1">Payment For Purchase Consideration Related To Prior Period Acquisitions</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions_lbl" xml:lang="en-US" id="id_13580812_3117671_2_1">Purchase consideration payments related to prior-period acquisitions</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions" xlink:to="md_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3076291_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_13580812_3076291_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/2018/elts/us-gaap-2018-01-31.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_13580812_3077063_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_13580812_3077063_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/2018/elts/us-gaap-2018-01-31.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_13580812_3076840_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_13580812_3076840_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/2018/elts/us-gaap-2018-01-31.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_13580812_3076853_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_13580812_3076853_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/2018/elts/us-gaap-2018-01-31.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_13580812_3076313_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_13580812_3076313_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/2018/elts/us-gaap-2018-01-31.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_13580812_3076327_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_13580812_3076327_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-20180630.xsd#md_PercentageOfNetPatientServiceRevenueByTypeOfPayor" xlink:label="md_PercentageOfNetPatientServiceRevenueByTypeOfPayor"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_PercentageOfNetPatientServiceRevenueByTypeOfPayor_lbl" xml:lang="en-US" id="id_13580812_3382903_3_1">Percentage of net patient service revenue by type payor.</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_PercentageOfNetPatientServiceRevenueByTypeOfPayor_lbl" xml:lang="en-US" id="id_13580812_3382903_1_1">Percentage Of Net Patient Service Revenue By Type Of Payor</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_PercentageOfNetPatientServiceRevenueByTypeOfPayor_lbl" xml:lang="en-US" id="id_13580812_3382903_2_1">Percentage of net patient service revenue</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_PercentageOfNetPatientServiceRevenueByTypeOfPayor" xlink:to="md_PercentageOfNetPatientServiceRevenueByTypeOfPayor_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20180630.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_13580812_3321594_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_13580812_3321594_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_13580812_3321594_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/2018/elts/us-gaap-2018-01-31.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_13580812_3076363_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_13580812_3076363_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/2018/elts/us-gaap-2018-01-31.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_13580812_3076892_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_13580812_3076892_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-20180630.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_13580812_3193980_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_13580812_3193980_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_13580812_3193980_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-20180630.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_13580812_3150676_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_13580812_3150676_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_13580812_3150676_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/2018/elts/us-gaap-2018-01-31.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_13580812_3077612_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_13580812_3077612_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/2018/elts/us-gaap-2018-01-31.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_13580812_3077614_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_13580812_3077614_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/2018/elts/us-gaap-2018-01-31.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_13580812_3077841_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_13580812_3077841_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/2018/elts/us-gaap-2018-01-31.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_13580812_3077618_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_13580812_3077618_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/2018/elts/us-gaap-2018-01-31.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_13580812_3076444_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_13580812_3076444_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-20180630.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_13580812_3302268_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_13580812_3302268_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_13580812_3302268_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/2018/elts/us-gaap-2018-01-31.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_13580812_3077144_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_13580812_3077144_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/2018/elts/us-gaap-2018-01-31.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_13580812_3077904_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_13580812_3077904_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/2018/elts/us-gaap-2018-01-31.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_13580812_3077155_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_13580812_3077155_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/2018/elts/us-gaap-2018-01-31.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_13580812_3077186_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_13580812_3077186_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/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets" xlink:label="us-gaap_ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets_lbl" xml:lang="en-US" id="id_13580812_3077949_1_1">Proceeds from Sales of Business, Affiliate and Productive Assets</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets_lbl" xml:lang="en-US" id="id_13580812_3077949_2_1">Proceeds from sale of controlling interest in assets</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets" xlink:to="us-gaap_ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductOrServiceAxis" xlink:label="srt_ProductOrServiceAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="srt_ProductOrServiceAxis_lbl" xml:lang="en-US" id="id_13580812_3077210_1_1">Product and Service [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="srt_ProductOrServiceAxis_lbl" xml:lang="en-US" id="id_13580812_3077210_2_1">Product and Service [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductOrServiceAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductsAndServicesDomain" xlink:label="srt_ProductsAndServicesDomain"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="srt_ProductsAndServicesDomain_lbl" xml:lang="en-US" id="id_13580812_3077211_1_1">Product and Service [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="srt_ProductsAndServicesDomain_lbl" xml:lang="en-US" id="id_13580812_3077211_2_1">Product and Service [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="srt_ProductsAndServicesDomain" xlink:to="srt_ProductsAndServicesDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3078267_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_13580812_3078267_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_13580812_3078267_6_1">Net income</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/2018/elts/us-gaap-2018-01-31.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_13580812_3077229_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_13580812_3077229_2_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/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:label="srt_RangeAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="srt_RangeAxis_lbl" xml:lang="en-US" id="id_13580812_3078512_1_1">Range [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="srt_RangeAxis_lbl" xml:lang="en-US" id="id_13580812_3078512_2_1">Range [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="srt_RangeAxis" xlink:to="srt_RangeAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:label="srt_RangeMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="srt_RangeMember_lbl" xml:lang="en-US" id="id_13580812_3077288_1_1">Range [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="srt_RangeMember_lbl" xml:lang="en-US" id="id_13580812_3077288_2_1">Range [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="srt_RangeMember" xlink:to="srt_RangeMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3078382_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_13580812_3078382_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-20180630.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_13580812_3350245_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_13580812_3350245_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_13580812_3350245_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="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3078057_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_13580812_3078057_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/2018/elts/us-gaap-2018-01-31.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_13580812_3078633_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_13580812_3078633_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="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedCashAndCashEquivalentsCashAndCashEquivalentsMember" xlink:label="us-gaap_RestrictedCashAndCashEquivalentsCashAndCashEquivalentsMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RestrictedCashAndCashEquivalentsCashAndCashEquivalentsMember_lbl" xml:lang="en-US" id="id_13580812_3078088_1_1">Cash and Cash Equivalents [Domain]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RestrictedCashAndCashEquivalentsCashAndCashEquivalentsMember_lbl" xml:lang="en-US" id="id_13580812_3078088_2_1">Cash and Cash Equivalents [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RestrictedCashAndCashEquivalentsCashAndCashEquivalentsMember" xlink:to="us-gaap_RestrictedCashAndCashEquivalentsCashAndCashEquivalentsMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedCashCurrent" xlink:label="us-gaap_RestrictedCashCurrent"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RestrictedCashCurrent_lbl" xml:lang="en-US" id="id_13580812_3079168_1_1">Restricted Cash, Current</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_RestrictedCashCurrent_lbl" xml:lang="en-US" id="id_13580812_3079168_2_1">Restricted cash</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_RestrictedCashCurrent" xlink:to="us-gaap_RestrictedCashCurrent_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3079512_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_13580812_3079512_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/2018/elts/us-gaap-2018-01-31.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_13580812_3079518_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_13580812_3079518_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/2018/elts/us-gaap-2018-01-31.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_13580812_3079374_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_13580812_3079374_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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax" xlink:label="us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax_lbl" xml:lang="en-US" id="id_13580812_3079398_1_1">Revenue from Contract with Customer, Including Assessed Tax</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ScheduleOfFinancingReceivablesLineItems_lbl" xml:lang="en-US" id="id_13580812_3086951_3_1">Schedule of financing receivables.</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfHeldToMaturitySecuritiesTable" xlink:label="us-gaap_ScheduleOfHeldToMaturitySecuritiesTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfHeldToMaturitySecuritiesTable_lbl" xml:lang="en-US" id="id_13580812_3079717_1_1">Debt Securities, Held-to-maturity [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfHeldToMaturitySecuritiesTable_lbl" xml:lang="en-US" id="id_13580812_3079717_2_1">Debt Securities, Held-to-maturity [Table]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfRevenueSourcesHealthCareOrganizationTable_lbl" xml:lang="en-US" id="id_13580812_3080244_2_1">Schedule of Revenue Sources, Health Care Organization [Table]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_lbl" xml:lang="en-US" id="id_13580812_3079002_1_1">Schedule of Share-based Compensation Arrangements by Share-based Payment Award [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable_lbl" xml:lang="en-US" id="id_13580812_3079002_2_1">Schedule of Share-based Compensation Arrangements by Share-based Payment Award [Table]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod_lbl" xml:lang="en-US" id="id_13580812_3080378_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod_lbl" xml:lang="en-US" id="id_13580812_3079788_2_1">Vesting period of options, maximum years</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_lbl" xml:lang="en-US" id="id_13580812_3080537_1_1">Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems_lbl" xml:lang="en-US" id="id_13580812_3080537_2_1">Share-based Compensation Arrangement by Share-based Payment Award [Line Items]</label>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent_lbl" xml:lang="en-US" id="id_13580812_3080167_1_1">Share-based Compensation Arrangement by Share-based Payment Award, Purchase Price of Common Stock, Percent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent_lbl" xml:lang="en-US" id="id_13580812_3080167_2_1">Percentage of market value of common stock at which employees are permitted to purchase</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent_lbl"/>
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    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_lbl" xml:lang="en-US" id="id_13580812_3079817_1_1">Equity Award [Domain]</label>
    <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_13580812_3079817_2_1">Equity Award [Domain]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation" xlink:label="us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation_lbl" xml:lang="en-US" id="id_13580812_3079833_1_1">Shares Paid for Tax Withholding for Share Based Compensation</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation_lbl" xml:lang="en-US" id="id_13580812_3079833_2_1">Number of shares 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_SharesPaidForTaxWithholdingForShareBasedCompensation" xlink:to="us-gaap_SharesPaidForTaxWithholdingForShareBasedCompensation_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20180630.xsd#md_ShortTermInvestmentMaturityPeriod" xlink:label="md_ShortTermInvestmentMaturityPeriod"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_ShortTermInvestmentMaturityPeriod_lbl" xml:lang="en-US" id="id_13580812_3226697_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_13580812_3226697_1_1">Short Term Investment Maturity Period</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_ShortTermInvestmentMaturityPeriod_lbl" xml:lang="en-US" id="id_13580812_3226697_2_1">Short-Term investments maturity period, in years</label>
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    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementBusinessSegmentsAxis" xlink:label="us-gaap_StatementBusinessSegmentsAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StatementBusinessSegmentsAxis_lbl" xml:lang="en-US" id="id_13580812_3081292_1_1">Segments [Axis]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StatementBusinessSegmentsAxis_lbl" xml:lang="en-US" id="id_13580812_3081292_2_1">Segments [Axis]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StatementBusinessSegmentsAxis" xlink:to="us-gaap_StatementBusinessSegmentsAxis_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:label="us-gaap_StatementEquityComponentsAxis"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StatementEquityComponentsAxis_lbl" xml:lang="en-US" id="id_13580812_3080925_1_1">Equity Components [Axis]</label>
    <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_13580812_3080925_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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementLineItems" xlink:label="us-gaap_StatementLineItems"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StatementLineItems_lbl" xml:lang="en-US" id="id_13580812_3080927_1_1">Statement [Line Items]</label>
    <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_13580812_3080927_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"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementOfCashFlowsAbstract" xlink:label="us-gaap_StatementOfCashFlowsAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StatementOfCashFlowsAbstract_lbl" xml:lang="en-US" id="id_13580812_3079913_1_1">Statement of Cash Flows [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StatementOfCashFlowsAbstract_lbl" xml:lang="en-US" id="id_13580812_3079913_2_1">Statement of Cash Flows [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_StatementOfCashFlowsAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementOfFinancialPositionAbstract" xlink:label="us-gaap_StatementOfFinancialPositionAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StatementOfFinancialPositionAbstract_lbl" xml:lang="en-US" id="id_13580812_3081293_1_1">Statement of Financial Position [Abstract]</label>
    <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_13580812_3081293_2_1">Statement of Financial Position [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_StatementOfFinancialPositionAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementTable" xlink:label="us-gaap_StatementTable"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StatementTable_lbl" xml:lang="en-US" id="id_13580812_3081160_1_1">Statement [Table]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StatementTable_lbl" xml:lang="en-US" id="id_13580812_3081160_2_1">Statement [Table]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementTable_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquity" xlink:label="us-gaap_StockholdersEquity"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockholdersEquity_lbl" xml:lang="en-US" id="id_13580812_3081310_1_1">Stockholders' Equity Attributable to Parent</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/totalLabel" xlink:label="us-gaap_StockholdersEquity_lbl" xml:lang="en-US" id="id_13580812_3081310_6_1">Total shareholders' equity</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockholdersEquity" xlink:to="us-gaap_StockholdersEquity_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquityAbstract" xlink:label="us-gaap_StockholdersEquityAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_StockholdersEquityAbstract_lbl" xml:lang="en-US" id="id_13580812_3081311_1_1">Stockholders' Equity Attributable to Parent [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockholdersEquityAbstract_lbl" xml:lang="en-US" id="id_13580812_3081311_2_1">Shareholders' equity:</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_StockholdersEquityAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3081324_1_1">Stock Issued During Period, Shares, Employee Stock Purchase Plans</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans_lbl" xml:lang="en-US" id="id_13580812_3081324_2_1">Aggregate number Shares issued under Stock Purchase Plans</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans" xlink:to="us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockRepurchasedDuringPeriodShares" xlink:label="us-gaap_StockRepurchasedDuringPeriodShares"/>
    <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_13580812_3081340_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_13580812_3081340_2_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/2018/elts/us-gaap-2018-01-31.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_13580812_3081193_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_13580812_3081193_2_1">Common stock repurchased</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_StockRepurchasedDuringPeriodValue" xlink:to="us-gaap_StockRepurchasedDuringPeriodValue_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TextBlockAbstract" xlink:label="us-gaap_TextBlockAbstract"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_TextBlockAbstract_lbl" xml:lang="en-US" id="id_13580812_3081941_1_1">Text Block [Abstract]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_TextBlockAbstract_lbl" xml:lang="en-US" id="id_13580812_3081941_2_1">Text Block [Abstract]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_TextBlockAbstract" xlink:to="us-gaap_TextBlockAbstract_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ThirdPartyPayorMember" xlink:label="us-gaap_ThirdPartyPayorMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="us-gaap_ThirdPartyPayorMember_lbl" xml:lang="en-US" id="id_13580812_3081046_1_1">Third-Party Payor [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="us-gaap_ThirdPartyPayorMember_lbl" xml:lang="en-US" id="id_13580812_3081046_2_1">Other Third-Parties [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_ThirdPartyPayorMember" xlink:to="us-gaap_ThirdPartyPayorMember_lbl"/>
    <loc xlink:type="locator" xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_TradingSymbol" xlink:label="dei_TradingSymbol"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="dei_TradingSymbol_lbl" xml:lang="en-US" id="id_13580812_3080759_1_1">Trading Symbol</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="dei_TradingSymbol_lbl" xml:lang="en-US" id="id_13580812_3080759_2_1">Trading Symbol</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="dei_TradingSymbol" xlink:to="dei_TradingSymbol_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20180630.xsd#md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember" xlink:label="md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember_lbl" xml:lang="en-US" id="id_13580812_3266135_3_1">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_TwoThousandFifteenNonQualifiedStockPurchasePlanMember_lbl" xml:lang="en-US" id="id_13580812_3266135_1_1">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_TwoThousandFifteenNonQualifiedStockPurchasePlanMember_lbl" xml:lang="en-US" id="id_13580812_3266135_2_1">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_TwoThousandFifteenNonQualifiedStockPurchasePlanMember" xlink:to="md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember_lbl"/>
    <loc xlink:type="locator" xlink:href="md-20180630.xsd#md_UnnamedCorporateJointVentureMember" xlink:label="md_UnnamedCorporateJointVentureMember"/>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/documentation" xlink:label="md_UnnamedCorporateJointVentureMember_lbl" xml:lang="en-US" id="id_13580812_3295964_3_1">Unnamed Corporate Joint Venture [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/label" xlink:label="md_UnnamedCorporateJointVentureMember_lbl" xml:lang="en-US" id="id_13580812_3295964_1_1">Unnamed Corporate Joint Venture [Member]</label>
    <label xlink:type="resource" xlink:role="http://www.xbrl.org/2003/role/terseLabel" xlink:label="md_UnnamedCorporateJointVentureMember_lbl" xml:lang="en-US" id="id_13580812_3295964_2_1">Unnamed Corporate Joint Venture [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="md_UnnamedCorporateJointVentureMember" xlink:to="md_UnnamedCorporateJointVentureMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.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_13580812_3081528_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_13580812_3081528_2_1">Federal Home Loan Securities [Member]</label>
    <labelArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/concept-label" xlink:from="us-gaap_USGovernmentSponsoredEnterprisesDebtSecuritiesMember" xlink:to="us-gaap_USGovernmentSponsoredEnterprisesDebtSecuritiesMember_lbl"/>
    <loc xlink:type="locator" xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_USStatesAndPoliticalSubdivisionsMember" xlink:label="us-gaap_USStatesAndPoliticalSubdivisionsMember"/>
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</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>EX-101.PRE
<SEQUENCE>10
<FILENAME>md-20180630_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: 2018-08-02T13:15:49Z -->
<!-- Copyright (c) 2017 Donnelley Financial, LLC. All Rights Reserved. -->
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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_EntityCommonStockSharesOutstanding', window );">Entity Common Stock, Shares Outstanding</a></td>
<td class="text">&#160;<span></span>
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<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">
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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>
<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>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">
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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>
<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 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">
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<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">
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<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 12<br> -Subsection b-2<br></p></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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<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">
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<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), (5) Smaller Reporting Accelerated Filer or (6) Smaller Reporting Company and Large 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>Reference 1: http://www.xbrl.org/2003/role/presentationRef<br> -Publisher SEC<br> -Name Regulation 12B<br> -Number 240<br> -Section 12<br> -Subsection b-2<br></p></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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<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 12<br> -Subsection b-2<br></p></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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<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>
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<td style="white-space:nowrap;">dei_TradingSymbol</td>
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<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>
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<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Condensed Consolidated Balance Sheets (Unaudited) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Dec. 31, 2017</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_AssetsCurrentAbstract', window );"><strong>Current assets:</strong></a></td>
<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_CashAndCashEquivalentsAtCarryingValue', window );">Cash and cash equivalents</a></td>
<td class="nump">$ 38,056<span></span>
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<td class="nump">$ 60,200<span></span>
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<td class="nump">19,000<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_HeldToMaturitySecuritiesCurrent', window );">Short-term investments</a></td>
<td class="nump">9,902<span></span>
</td>
<td class="nump">10,292<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_AccountsReceivableNetCurrent', window );">Accounts receivable, net</a></td>
<td class="nump">527,997<span></span>
</td>
<td class="nump">503,999<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_PrepaidExpenseCurrent', window );">Prepaid expenses</a></td>
<td class="nump">15,752<span></span>
</td>
<td class="nump">15,584<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_OtherAssetsCurrent', window );">Other current assets</a></td>
<td class="nump">14,223<span></span>
</td>
<td class="nump">37,160<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_AssetsCurrent', window );">Total current assets</a></td>
<td class="nump">624,930<span></span>
</td>
<td class="nump">627,235<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_RestrictedCashNoncurrent', window );">Restricted cash</a></td>
<td class="nump">1,000<span></span>
</td>
<td class="nump">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_HeldToMaturitySecuritiesNoncurrent', window );">Investments</a></td>
<td class="nump">90,186<span></span>
</td>
<td class="nump">80,682<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_PropertyPlantAndEquipmentNet', window );">Property and equipment, net</a></td>
<td class="nump">131,922<span></span>
</td>
<td class="nump">123,536<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">4,304,740<span></span>
</td>
<td class="nump">4,283,963<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_FiniteLivedIntangibleAssetsNet', window );">Intangible assets, net</a></td>
<td class="nump">614,226<span></span>
</td>
<td class="nump">639,928<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_OtherAssetsNoncurrent', window );">Other assets</a></td>
<td class="nump">92,634<span></span>
</td>
<td class="nump">91,934<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_Assets', window );">Total assets</a></td>
<td class="nump">5,859,638<span></span>
</td>
<td class="nump">5,867,278<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_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="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_AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent', window );">Accounts payable and accrued expenses</a></td>
<td class="nump">358,255<span></span>
</td>
<td class="nump">438,017<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_LongTermDebtAndCapitalLeaseObligationsCurrent', window );">Current portion of long-term debt and capital lease obligations</a></td>
<td class="nump">860<span></span>
</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_AccruedIncomeTaxesCurrent', window );">Income taxes payable</a></td>
<td class="nump">52,098<span></span>
</td>
<td class="nump">92,007<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_LiabilitiesCurrent', window );">Total current liabilities</a></td>
<td class="nump">411,213<span></span>
</td>
<td class="nump">531,425<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_LongTermLineOfCredit', window );">Line of credit</a></td>
<td class="nump">1,149,500<span></span>
</td>
<td class="nump">1,110,500<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_LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit', window );">Long-term debt and capital lease obligations, net</a></td>
<td class="nump">741,612<span></span>
</td>
<td class="nump">740,923<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_MalpracticeLossContingencyAccrualUndiscountedNoncurrent', window );">Long-term professional liabilities</a></td>
<td class="nump">207,687<span></span>
</td>
<td class="nump">212,274<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_DeferredTaxLiabilitiesNoncurrent', window );">Deferred income taxes</a></td>
<td class="nump">126,505<span></span>
</td>
<td class="nump">147,797<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_OtherLiabilitiesNoncurrent', window );">Other liabilities</a></td>
<td class="nump">36,199<span></span>
</td>
<td class="nump">57,905<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_Liabilities', window );">Total liabilities</a></td>
<td class="nump">2,672,716<span></span>
</td>
<td class="nump">2,800,824<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_CommitmentsAndContingencies', window );">Commitments and contingencies</a></td>
<td class="text"> <span></span>
</td>
<td class="text"> <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_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="re">
<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="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_CommonStockValue', window );">Common stock; $.01 par value; 200,000 shares authorized; 93,374 and 93,721 shares issued and outstanding, respectively</a></td>
<td class="nump">934<span></span>
</td>
<td class="nump">937<span></span>
</td>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_AdditionalPaidInCapitalCommonStock', window );">Additional paid-in capital</a></td>
<td class="nump">1,032,573<span></span>
</td>
<td class="nump">1,017,328<span></span>
</td>
</tr>
<tr class="ro">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RetainedEarningsAccumulatedDeficit', window );">Retained earnings</a></td>
<td class="nump">2,153,415<span></span>
</td>
<td class="nump">2,048,189<span></span>
</td>
</tr>
<tr class="reu">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_StockholdersEquity', window );">Total shareholders' equity</a></td>
<td class="nump">3,186,922<span></span>
</td>
<td class="nump">3,066,454<span></span>
</td>
</tr>
<tr class="rou">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_LiabilitiesAndStockholdersEquity', window );">Total liabilities and shareholders' equity</a></td>
<td class="nump">$ 5,859,638<span></span>
</td>
<td class="nump">$ 5,867,278<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/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 606<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=109196051&amp;loc=SL49130549-203045<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<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_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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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><br>Reference 2: http://www.xbrl.org/2003/role/disclosureRef<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=115929826&amp;loc=d3e8736-108599<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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://fasb.org/us-gaap/role/ref/legacyRef<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 2: http://fasb.org/us-gaap/role/ref/legacyRef<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 3: http://fasb.org/us-gaap/role/ref/legacyRef<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>
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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>
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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_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>
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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>
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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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&amp;loc=d3e3044-108585<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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 3: http://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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 3: http://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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_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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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 2: http://fasb.org/us-gaap/role/ref/legacyRef<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 3: http://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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=99380562&amp;loc=d3e13770-109266<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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 of investment in debt security measured at amortized cost (held-to-maturity), classified as current.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<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=109979856&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_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 of investment in debt security measured at amortized cost (held-to-maturity), 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://fasb.org/us-gaap/role/ref/legacyRef<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=109979856&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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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>
<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_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://fasb.org/us-gaap/role/ref/legacyRef<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>
</tr>
<tr>
<td style="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_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://fasb.org/us-gaap/role/ref/legacyRef<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>
</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_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://fasb.org/us-gaap/role/ref/legacyRef<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>
<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_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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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>
</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://fasb.org/us-gaap/role/ref/legacyRef<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 2: http://fasb.org/us-gaap/role/ref/legacyRef<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 3: http://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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_PropertyPlantAndEquipmentNet</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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<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>
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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_RestrictedCashCurrent">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 current. 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/2009/role/commonPracticeRef<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/2009/role/commonPracticeRef<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 3: http://www.xbrl.org/2009/role/commonPracticeRef<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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RestrictedCashCurrent</td>
</tr>
<tr>
<td style="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/2009/role/commonPracticeRef<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 2: http://www.xbrl.org/2009/role/commonPracticeRef<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/2009/role/commonPracticeRef<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 4: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 954<br> -SubTopic 305<br> -Section 45<br> -Paragraph 1<br> -URI http://asc.fasb.org/extlink&amp;oid=84242212&amp;loc=d3e2352-115587<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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> Balance Type:</strong></td>
<td>debit</td>
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<tr>
<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_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://fasb.org/us-gaap/role/ref/legacyRef<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><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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 3: http://fasb.org/us-gaap/role/ref/legacyRef<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_RetainedEarningsAccumulatedDeficit</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>
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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://fasb.org/us-gaap/role/ref/legacyRef<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 2: http://fasb.org/us-gaap/role/ref/legacyRef<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 3: http://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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>
</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>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_StockholdersEquityAbstract">
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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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<td>xbrli:stringItemType</td>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6765537232">
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<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - $ / shares<br></strong></div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<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_StatementOfFinancialPositionAbstract', window );"><strong>Statement of Financial Position [Abstract]</strong></a></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_us-gaap_PreferredStockParOrStatedValuePerShare', window );">Preferred stock, par value</a></td>
<td class="nump">$ 0.01<span></span>
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<td class="nump">$ 0.01<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_PreferredStockSharesAuthorized', window );">Preferred stock, shares authorized</a></td>
<td class="nump">1,000,000<span></span>
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<td class="nump">1,000,000<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_PreferredStockSharesIssued', window );">Preferred stock, issued</a></td>
<td class="nump">0<span></span>
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<td class="nump">0<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_CommonStockParOrStatedValuePerShare', window );">Common stock, par value</a></td>
<td class="nump">$ 0.01<span></span>
</td>
<td class="nump">$ 0.01<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_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>
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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_CommonStockSharesIssued', window );">Common stock, shares issued</a></td>
<td class="nump">93,374,000<span></span>
</td>
<td class="nump">93,721,000<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_CommonStockSharesOutstanding', window );">Common stock, shares outstanding</a></td>
<td class="nump">93,374,000<span></span>
</td>
<td class="nump">93,721,000<span></span>
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<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://fasb.org/us-gaap/role/ref/legacyRef<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>
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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>
<td>num:perShareItemType</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>instant</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_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://fasb.org/us-gaap/role/ref/legacyRef<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>
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<td style="white-space:nowrap;">us-gaap_CommonStockSharesAuthorized</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:sharesItemType</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>instant</td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CommonStockSharesIssued">
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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>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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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=109259400&amp;loc=d3e21463-112644<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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_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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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>
</div></td></tr>
</table>
<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>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td>duration</td>
</tr>
</table></div>
</div></td></tr>
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</div>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6766427376">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Condensed Consolidated Statements of Income (Unaudited) - USD ($)<br> shares in Thousands, $ in Thousands</strong></div></th>
<th class="th" colspan="2">3 Months Ended</th>
<th class="th" colspan="2">6 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 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_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>
</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">$ 620,980<span></span>
</td>
<td class="nump">$ 561,418<span></span>
</td>
<td class="nump">$ 1,252,810<span></span>
</td>
<td class="nump">$ 1,133,803<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">31,833<span></span>
</td>
<td class="nump">30,872<span></span>
</td>
<td class="nump">62,488<span></span>
</td>
<td class="nump">58,668<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">107,908<span></span>
</td>
<td class="nump">103,015<span></span>
</td>
<td class="nump">216,684<span></span>
</td>
<td class="nump">206,780<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">26,518<span></span>
</td>
<td class="nump">25,735<span></span>
</td>
<td class="nump">52,681<span></span>
</td>
<td class="nump">51,349<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">787,239<span></span>
</td>
<td class="nump">721,040<span></span>
</td>
<td class="nump">1,584,663<span></span>
</td>
<td class="nump">1,450,600<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">128,679<span></span>
</td>
<td class="nump">121,904<span></span>
</td>
<td class="nump">233,112<span></span>
</td>
<td class="nump">227,941<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">1,202<span></span>
</td>
<td class="nump">365<span></span>
</td>
<td class="nump">2,666<span></span>
</td>
<td class="nump">941<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">(21,604)<span></span>
</td>
<td class="num">(18,535)<span></span>
</td>
<td class="num">(41,539)<span></span>
</td>
<td class="num">(36,287)<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="nump">1,257<span></span>
</td>
<td class="nump">689<span></span>
</td>
<td class="nump">2,782<span></span>
</td>
<td class="nump">1,486<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">(19,145)<span></span>
</td>
<td class="num">(17,481)<span></span>
</td>
<td class="num">(36,091)<span></span>
</td>
<td class="num">(33,860)<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">109,534<span></span>
</td>
<td class="nump">104,423<span></span>
</td>
<td class="nump">197,021<span></span>
</td>
<td class="nump">194,081<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="num">(30,122)<span></span>
</td>
<td class="num">(40,725)<span></span>
</td>
<td class="num">(54,181)<span></span>
</td>
<td class="num">(75,692)<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="nump">$ 79,412<span></span>
</td>
<td class="nump">$ 63,698<span></span>
</td>
<td class="nump">$ 142,840<span></span>
</td>
<td class="nump">$ 118,389<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:</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_EarningsPerShareBasic', window );">Earnings per share, Basic</a></td>
<td class="nump">$ 0.85<span></span>
</td>
<td class="nump">$ 0.69<span></span>
</td>
<td class="nump">$ 1.54<span></span>
</td>
<td class="nump">$ 1.28<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">$ 0.85<span></span>
</td>
<td class="nump">$ 0.69<span></span>
</td>
<td class="nump">$ 1.53<span></span>
</td>
<td class="nump">$ 1.27<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>
</tr>
<tr class="re">
<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">92,987<span></span>
</td>
<td class="nump">92,181<span></span>
</td>
<td class="nump">92,922<span></span>
</td>
<td class="nump">92,270<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">93,529<span></span>
</td>
<td class="nump">92,812<span></span>
</td>
<td class="nump">93,516<span></span>
</td>
<td class="nump">92,977<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_srt_ProductOrServiceAxis=us-gaap_HealthCareMember', window );">Health Care</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_RevenueFromContractWithCustomerIncludingAssessedTax', window );">Net revenue</a></td>
<td class="nump">$ 915,918<span></span>
</td>
<td class="nump">$ 842,944<span></span>
</td>
<td class="nump">$ 1,817,775<span></span>
</td>
<td class="nump">$ 1,678,541<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/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 22<br> -Subparagraph (e)<br> -URI http://asc.fasb.org/extlink&amp;oid=115929826&amp;loc=d3e8736-108599<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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>
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<td><strong> Data Type:</strong></td>
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</tr>
<tr>
<td><strong> Balance Type:</strong></td>
<td>debit</td>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
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</tr>
</table></div>
</div></td></tr>
</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 );">- 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>
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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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<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/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 220<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(19))<br> -URI http://asc.fasb.org/extlink&amp;oid=114873790&amp;loc=SL114874131-224263<br><br>Reference 2: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 7<br> -URI http://asc.fasb.org/extlink&amp;oid=109260490&amp;loc=d3e1337-109256<br><br>Reference 3: http://www.xbrl.org/2003/role/exampleRef<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=109256448&amp;loc=d3e4984-109258<br><br>Reference 4: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<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=115205541&amp;loc=SL114868664-224227<br><br>Reference 5: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 250<br> -SubTopic 10<br> -Section 50<br> -Paragraph 11<br> -URI http://asc.fasb.org/extlink&amp;oid=109234566&amp;loc=d3e22694-107794<br><br>Reference 6: http://www.xbrl.org/2003/role/disclosureRef<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 7: http://www.xbrl.org/2003/role/disclosureRef<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=109260490&amp;loc=d3e1252-109256<br><br>Reference 8: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 220<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(23))<br> -URI http://asc.fasb.org/extlink&amp;oid=114873765&amp;loc=SL114874048-224260<br><br>Reference 9: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 60B<br> -Subparagraph (d)<br> -URI http://asc.fasb.org/extlink&amp;oid=109260490&amp;loc=SL5780133-109256<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_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/exampleRef<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=109256448&amp;loc=d3e4984-109258<br><br>Reference 2: http://www.xbrl.org/2003/role/disclosureRef<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=109260490&amp;loc=d3e1252-109256<br><br>Reference 3: http://www.xbrl.org/2003/role/disclosureRef<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 4: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 220<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(23))<br> -URI http://asc.fasb.org/extlink&amp;oid=114873765&amp;loc=SL114874048-224260<br><br>Reference 5: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 250<br> -SubTopic 10<br> -Section 50<br> -Paragraph 11<br> -URI http://asc.fasb.org/extlink&amp;oid=109234566&amp;loc=d3e22694-107794<br><br>Reference 6: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 7<br> -URI http://asc.fasb.org/extlink&amp;oid=109260490&amp;loc=d3e1337-109256<br><br>Reference 7: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<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=115205541&amp;loc=SL114868664-224227<br><br>Reference 8: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 260<br> -SubTopic 10<br> -Section 45<br> -Paragraph 60B<br> -Subparagraph (d)<br> -URI http://asc.fasb.org/extlink&amp;oid=109260490&amp;loc=SL5780133-109256<br><br>Reference 9: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 220<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(19))<br> -URI http://asc.fasb.org/extlink&amp;oid=114873790&amp;loc=SL114874131-224263<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<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=115205541&amp;loc=SL114868664-224227<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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_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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<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=115205541&amp;loc=SL114868664-224227<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 220<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(8))<br> -URI http://asc.fasb.org/extlink&amp;oid=114873790&amp;loc=SL114874131-224263<br><br>Reference 4: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 250<br> -SubTopic 10<br> -Section 50<br> -Paragraph 11<br> -URI http://asc.fasb.org/extlink&amp;oid=109234566&amp;loc=d3e22694-107794<br><br>Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 220<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(15))<br> -URI http://asc.fasb.org/extlink&amp;oid=114873765&amp;loc=SL114874048-224260<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<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=115205541&amp;loc=SL114868664-224227<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 944<br> -SubTopic 220<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.7-04(10))<br> -URI http://asc.fasb.org/extlink&amp;oid=114873790&amp;loc=SL114874131-224263<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&amp;loc=d3e3602-108585<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 220<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04(13)(f))<br> -URI http://asc.fasb.org/extlink&amp;oid=114873765&amp;loc=SL114874048-224260<br><br>Reference 5: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 22<br> -Subparagraph (g)<br> -URI http://asc.fasb.org/extlink&amp;oid=115929826&amp;loc=d3e8736-108599<br><br>Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef<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=109237563&amp;loc=d3e33749-111570<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 22<br> -Subparagraph (h)<br> -URI http://asc.fasb.org/extlink&amp;oid=115929826&amp;loc=d3e8736-108599<br><br>Reference 2: http://www.xbrl.org/2003/role/disclosureRef<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/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 740<br> -SubTopic 20<br> -Section 45<br> -Paragraph 2<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=109238882&amp;loc=d3e38679-109324<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 835<br> -SubTopic 20<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=6450988&amp;loc=d3e26243-108391<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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=114775744&amp;loc=d3e28555-108399<br><br>Reference 3: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 22<br> -Subparagraph (d)<br> -URI http://asc.fasb.org/extlink&amp;oid=115929826&amp;loc=d3e8736-108599<br><br>Reference 4: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<br> -SubTopic 10<br> -Section S99<br> -Paragraph 2<br> -Subparagraph (210.5-03(11))<br> -URI http://asc.fasb.org/extlink&amp;oid=115205541&amp;loc=SL114868664-224227<br><br>Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 942<br> -SubTopic 220<br> -Section S99<br> -Paragraph 1<br> -Subparagraph (SX 210.9-04.9)<br> -URI http://asc.fasb.org/extlink&amp;oid=114873765&amp;loc=SL114874048-224260<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<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=115205541&amp;loc=SL114868664-224227<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<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=115205541&amp;loc=SL114868664-224227<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<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=115205541&amp;loc=SL114868664-224227<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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_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://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<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=115205541&amp;loc=SL114868664-224227<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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_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>
</tr>
<tr>
<td style="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_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/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<br> -SubTopic 10<br> -Section 45<br> -Paragraph 1A<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=114867106&amp;loc=SL7669619-108580<br><br>Reference 2: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=109239629&amp;loc=SL4573702-111684<br><br>Reference 3: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<br> -SubTopic 10<br> -Section 45<br> -Paragraph 1B<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=114867106&amp;loc=SL7669625-108580<br><br>Reference 4: http://www.xbrl.org/2003/role/disclosureRef<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=109239629&amp;loc=SL4573702-111684<br><br>Reference 5: http://www.xbrl.org/2003/role/disclosureRef<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=115929826&amp;loc=d3e8736-108599<br><br>Reference 6: http://www.xbrl.org/2003/role/exampleRef<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 7: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=109223946&amp;loc=d3e3000-108585<br><br>Reference 8: http://www.xbrl.org/2003/role/disclosureRef<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=108774443&amp;loc=SL4569616-111683<br><br>Reference 9: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 32<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=115929826&amp;loc=d3e8933-108599<br><br>Reference 10: http://www.xbrl.org/2003/role/exampleRef<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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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_RevenueFromContractWithCustomerIncludingAssessedTax">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 606<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=109196051&amp;loc=SL49130539-203045<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 606<br> -SubTopic 10<br> -Section 50<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=109196051&amp;loc=SL49130545-203045<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 606<br> -SubTopic 10<br> -Section 50<br> -Paragraph 4<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=109196051&amp;loc=SL49130543-203045<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax</td>
</tr>
<tr>
<td style="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_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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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=109260490&amp;loc=d3e1505-109256<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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109260490&amp;loc=d3e1448-109256<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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_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>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_srt_ProductOrServiceAxis=us-gaap_HealthCareMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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;">srt_ProductOrServiceAxis=us-gaap_HealthCareMember</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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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6763623568">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="2">6 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 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_NetCashProvidedByUsedInOperatingActivitiesAbstract', window );"><strong>Cash flows from operating activities:</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_ProfitLoss', window );">Net income</a></td>
<td class="nump">$ 142,840<span></span>
</td>
<td class="nump">$ 118,389<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 from operating activities:</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_DepreciationDepletionAndAmortization', window );">Depreciation and amortization</a></td>
<td class="nump">52,681<span></span>
</td>
<td class="nump">51,349<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">2,212<span></span>
</td>
<td class="nump">2,740<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">20,399<span></span>
</td>
<td class="nump">14,781<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">(21,211)<span></span>
</td>
<td class="nump">18,454<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">(2,148)<span></span>
</td>
<td class="num">(3,407)<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_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>
</tr>
<tr 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="num">(23,998)<span></span>
</td>
<td class="nump">18,361<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">(1,178)<span></span>
</td>
<td class="num">(666)<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">(317)<span></span>
</td>
<td class="num">(3,425)<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="num">(100,442)<span></span>
</td>
<td class="num">(87,862)<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_IncreaseDecreaseInAccruedIncomeTaxesPayable', window );">Income taxes payable</a></td>
<td class="num">(39,909)<span></span>
</td>
<td class="num">(15,900)<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">(65)<span></span>
</td>
<td class="num">(299)<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_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve', window );">Long-term professional liabilities</a></td>
<td class="num">(5,863)<span></span>
</td>
<td class="nump">1,016<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">(1,397)<span></span>
</td>
<td class="nump">2,282<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_NetCashProvidedByUsedInOperatingActivities', window );">Net cash provided from operating activities</a></td>
<td class="nump">21,604<span></span>
</td>
<td class="nump">115,813<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_NetCashProvidedByUsedInInvestingActivitiesAbstract', window );"><strong>Cash flows from investing activities:</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_PaymentsToAcquireBusinessesNetOfCashAcquired', window );">Acquisition payments, net of cash acquired</a></td>
<td class="num">(25,575)<span></span>
</td>
<td class="num">(113,746)<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">(15,884)<span></span>
</td>
<td class="num">(15,324)<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">5,995<span></span>
</td>
<td class="nump">7,290<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">(26,274)<span></span>
</td>
<td class="num">(21,909)<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_ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets', window );">Proceeds from sale of controlling interest in assets</a></td>
<td class="nump">22,764<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_PaymentsForProceedsFromOtherInvestingActivities', window );">Other</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">3,868<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_NetCashProvidedByUsedInInvestingActivities', window );">Net cash used in investing activities</a></td>
<td class="num">(38,974)<span></span>
</td>
<td class="num">(139,821)<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_NetCashProvidedByUsedInFinancingActivitiesAbstract', window );"><strong>Cash flows from financing activities:</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_ProceedsFromLinesOfCredit', window );">Borrowings on credit agreement</a></td>
<td class="nump">821,500<span></span>
</td>
<td class="nump">821,000<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_RepaymentsOfLinesOfCredit', window );">Payments on credit agreement</a></td>
<td class="num">(782,500)<span></span>
</td>
<td class="num">(754,000)<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_PaymentForContingentConsiderationLiabilityFinancingActivities', window );">Payments of contingent consideration liabilities</a></td>
<td class="num">(367)<span></span>
</td>
<td class="num">(1,961)<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_RepaymentsOfLongTermCapitalLeaseObligations', window );">Payments on capital lease obligations</a></td>
<td class="num">(636)<span></span>
</td>
<td class="num">(998)<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">9,389<span></span>
</td>
<td class="nump">13,990<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_PaymentsForRepurchaseOfCommonStock', window );">Repurchases of common stock</a></td>
<td class="num">(52,160)<span></span>
</td>
<td class="num">(70,192)<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_ProceedsFromMinorityShareholders', window );">Contribution from noncontrolling interests</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">894<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_NetCashProvidedByUsedInFinancingActivities', window );">Net cash (used in) provided from financing activities</a></td>
<td class="num">(4,774)<span></span>
</td>
<td class="nump">8,733<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_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect', window );">Net decrease in cash and cash equivalents</a></td>
<td class="num">(22,144)<span></span>
</td>
<td class="num">(15,275)<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 period</a></td>
<td class="nump">80,200<span></span>
</td>
<td class="nump">55,698<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 period</a></td>
<td class="nump">$ 58,056<span></span>
</td>
<td class="nump">$ 40,423<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/2009/role/commonPracticeRef<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=109223946&amp;loc=d3e3602-108585<br><br>Reference 2: http://www.xbrl.org/2003/role/disclosureRef<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=114775744&amp;loc=d3e28555-108399<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_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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&amp;loc=d3e3521-108585<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&amp;loc=d3e3044-108585<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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, cash equivalents, and cash and cash equivalents restricted to withdrawal or usage; including effect from exchange rate change. 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://fasb.org/us-gaap/role/ref/legacyRef<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><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect</td>
</tr>
<tr>
<td style="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_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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&amp;loc=d3e3602-108585<br><br>Reference 4: http://www.xbrl.org/2003/role/disclosureRef<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_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/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 22<br> -Subparagraph (e)<br> -URI http://asc.fasb.org/extlink&amp;oid=115929826&amp;loc=d3e8736-108599<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 liability to reflect the estimated ultimate cost of settling claims relating to insured events that have occurred on or before the balance sheet date, whether or not reported to the insurer at that date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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_IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve</td>
</tr>
<tr>
<td style="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>Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef<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=109223946&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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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_NetCashProvidedByUsedInFinancingActivities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 financing activities, including 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/disclosureRef<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=109223946&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_NetCashProvidedByUsedInFinancingActivities</td>
</tr>
<tr>
<td style="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_NetCashProvidedByUsedInFinancingActivitiesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_NetCashProvidedByUsedInFinancingActivitiesAbstract</td>
</tr>
<tr>
<td style="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_NetCashProvidedByUsedInInvestingActivities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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, including 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/disclosureRef<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=109223946&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_NetCashProvidedByUsedInInvestingActivities</td>
</tr>
<tr>
<td style="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_NetCashProvidedByUsedInInvestingActivitiesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_NetCashProvidedByUsedInInvestingActivitiesAbstract</td>
</tr>
<tr>
<td style="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_NetCashProvidedByUsedInOperatingActivities">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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, including 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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&amp;loc=d3e3536-108585<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&amp;loc=d3e3521-108585<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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_NetCashProvidedByUsedInOperatingActivities</td>
</tr>
<tr>
<td style="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_NetCashProvidedByUsedInOperatingActivitiesAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_NetCashProvidedByUsedInOperatingActivitiesAbstract</td>
</tr>
<tr>
<td style="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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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/2009/role/commonPracticeRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 235<br> -SubTopic 10<br> -Section S99<br> -Paragraph 3<br> -Subparagraph (SX 210.12-04(a))<br> -URI http://asc.fasb.org/extlink&amp;oid=26873400&amp;loc=d3e24072-122690<br><br>Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef<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=109223946&amp;loc=d3e3213-108585<br><br>Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef<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=109223946&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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&amp;loc=d3e3255-108585<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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_ProceedsFromMinorityShareholders</td>
</tr>
<tr>
<td style="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_ProceedsFromSaleMaturityAndCollectionsOfInvestments">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&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_ProceedsFromSaleMaturityAndCollectionsOfInvestments</td>
</tr>
<tr>
<td style="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_ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 cash proceeds received from a combination of transactions in which noncurrent assets are sold, which may include the sale of a business, an investment in an affiliate (including an equity method investee), property, plant and equipment and intangible assets. Excludes sales of trading, available-for-sale, and held-to-maturity 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/2009/role/commonPracticeRef<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=109223946&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_ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets</td>
</tr>
<tr>
<td style="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_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/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<br> -SubTopic 10<br> -Section 45<br> -Paragraph 1A<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=114867106&amp;loc=SL7669619-108580<br><br>Reference 2: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1A<br> -Subparagraph (a)(1)<br> -URI http://asc.fasb.org/extlink&amp;oid=109239629&amp;loc=SL4573702-111684<br><br>Reference 3: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 220<br> -SubTopic 10<br> -Section 45<br> -Paragraph 1B<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=114867106&amp;loc=SL7669625-108580<br><br>Reference 4: http://www.xbrl.org/2003/role/disclosureRef<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=109239629&amp;loc=SL4573702-111684<br><br>Reference 5: http://www.xbrl.org/2003/role/disclosureRef<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=115929826&amp;loc=d3e8736-108599<br><br>Reference 6: http://www.xbrl.org/2003/role/exampleRef<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 7: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 230<br> -SubTopic 10<br> -Section 45<br> -Paragraph 2<br> -URI http://asc.fasb.org/extlink&amp;oid=109223946&amp;loc=d3e3000-108585<br><br>Reference 8: http://www.xbrl.org/2003/role/disclosureRef<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=108774443&amp;loc=SL4569616-111683<br><br>Reference 9: http://www.xbrl.org/2003/role/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 280<br> -SubTopic 10<br> -Section 50<br> -Paragraph 32<br> -Subparagraph (c)<br> -URI http://asc.fasb.org/extlink&amp;oid=115929826&amp;loc=d3e8933-108599<br><br>Reference 10: http://www.xbrl.org/2003/role/exampleRef<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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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_RepaymentsOfLinesOfCredit">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&amp;loc=d3e3291-108585<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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>
</tr>
<tr>
<td style="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>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<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=109223946&amp;loc=d3e3291-108585<br></p></div>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6756209520">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Basis of Presentation and New Accounting Pronouncements<br></strong></div></th>
<th class="th" colspan="1">6 Months Ended</th>
</tr>
<tr><th class="th"><div>Jun. 30, 2018</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_OrganizationConsolidationBasisOfPresentationBusinessDescriptionAndAccountingPoliciesTextBlock', window );">Basis of Presentation and New Accounting Pronouncements</a></td>
<td class="text"><div>
 <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>1.</b></td>
 <td align="left" valign="top">
 <p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"><b>Basis of Presentation and New Accounting
 Pronouncements:</b></p>
 </td>
 </tr>
 </table>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 The accompanying unaudited Condensed Consolidated Financial
 Statements of the Company and the notes thereto presented in this
 <font style="white-space:nowrap">Form&#xA0;10-Q</font> have been
 prepared in accordance with the rules and regulations of the
 Securities and Exchange Commission (&#x201C;SEC&#x201D;) applicable
 to interim financial statements, and do not include all disclosures
 required by accounting principles generally accepted in the United
 States of America (&#x201C;GAAP&#x201D;) for complete financial
 statements. In the opinion of management, these financial
 statements include all adjustments, consisting only of normal
 recurring adjustments, necessary for a fair statement of the
 results of interim periods. The financial statements include all
 the accounts of MEDNAX, Inc. and its consolidated subsidiaries
 (collectively, &#x201C;MDX&#x201D;) together with the accounts of
 MDX&#x2019;s affiliated business corporations or professional
 associations, professional corporations, limited liability
 companies and partnerships (the &#x201C;affiliated professional
 contractors&#x201D;). Certain subsidiaries of MDX have contractual
 management arrangements with its affiliated professional
 contractors, which are separate legal entities that provide
 physician services in certain states and Puerto Rico. The terms
 &#x201C;MEDNAX&#x201D; and the &#x201C;Company&#x201D; refer
 collectively to MEDNAX, Inc., its subsidiaries and the affiliated
 professional contractors.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 The Company is a party to a joint venture in which it owns a 37.5%
 economic interest. In January 2018, the Company entered into an
 additional joint venture in which it owns a 49.0% economic
 interest. The Company accounts for these joint ventures under the
 equity method of accounting because the Company exercises
 significant influence over, but does not control, these entities.
 See Note 5 for more information regarding the January 2018 joint
 venture.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 The consolidated results of operations for the interim periods
 presented are not necessarily indicative of the results to be
 experienced for the entire fiscal year. In addition, the
 accompanying unaudited Condensed Consolidated Financial Statements
 and the notes thereto should be read in conjunction with the
 Consolidated Financial Statements and the notes thereto included in
 the Company&#x2019;s most recent Annual Report on <font style="white-space:nowrap">Form&#xA0;10-K</font> (the &#x201C;Form
 <font style="white-space:nowrap">10-K&#x201D;).</font></p>
 <p style="margin-top:18pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">
 <b>Recently Adopted Accounting Pronouncements</b></p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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. The guidance became effective
 for the Company on January&#xA0;1, 2018 and was adopted on a full
 retrospective basis. 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, 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 did not have
 an impact on our Consolidated Financial Statements, other than
 increased financial statement disclosures. The guidance requires
 increased disclosures, including qualitative and quantitative
 disclosures about the nature, amount, timing and uncertainty of
 revenue and cash flows arising from contracts with customers. See
 Note 4 for more information.</p>
 <p style="margin-top:18pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">
 <b>New Accounting Pronouncements</b></p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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 has completed the review of its existing lease
 portfolio and is accumulating all of the necessary information
 required to properly account for leases under the new guidance. The
 Company has selected a software application, inclusive of a lease
 administration module and an accounting module, and has begun the
 implementation process. The Company is in the process of designing
 workflows, business processes and internal controls surrounding the
 lease accounting process in order to meet the reporting and
 disclosure requirements. The Company&#x2019;s implementation and
 continued evaluation of this new guidance and its impacts are
 expected to continue through the third quarter of 2018.</p>
 </div><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>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for the general note to the financial statements for the reporting entity which may include, descriptions of the basis of presentation, business description, significant accounting policies, consolidations, reclassifications, new pronouncements not yet adopted and changes in accounting principles.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 810<br> -URI http://asc.fasb.org/topic&amp;trid=2197479<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 275<br> -URI http://asc.fasb.org/topic&amp;trid=2134479<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 250<br> -URI http://asc.fasb.org/topic&amp;trid=2122394<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<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;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6610285904">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Cash Equivalents and Investments<br></strong></div></th>
<th class="th" colspan="1">6 Months Ended</th>
</tr>
<tr><th class="th"><div>Jun. 30, 2018</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>
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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_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock', window );">Cash Equivalents and Investments</a></td>
<td class="text"><div>
 <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"><b>2.</b></td>
 <td valign="top" align="left">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 0pt" align="left"><b>Cash Equivalents and Investments:</b></p>
 </td>
 </tr>
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 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 As of June&#xA0;30, 2018 and December&#xA0;31, 2017, the
 Company&#x2019;s cash equivalents consisted entirely of money market
 funds totaling $2.4&#xA0;million and $9.2&#xA0;million,
 respectively.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 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.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 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 and equity securities.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 Investments held at June&#xA0;30, 2018 and December&#xA0;31, 2017
 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="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>
 <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="6" align="center"><b>June&#xA0;30, 2018</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, 2017</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">8,432</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">48,613</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</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>
 </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" 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">36,393</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,000</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>
 </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">1,470</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">5,180</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">4,165</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">9,902</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">90,186</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</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>
 </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>
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 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; 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="68%"></td>
 <td valign="bottom" width="10%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="10%"></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="2" align="center"><b>June&#xA0;30,&#xA0;2018</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>December&#xA0;31,&#xA0;2017</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">89,186</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">78,561</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Due after five years through six years</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,000</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,121</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">90,186</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>
 </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>
 </div><span></span>
</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">
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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://fasb.org/us-gaap/role/ref/legacyRef<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 2: http://fasb.org/us-gaap/role/ref/legacyRef<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 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 320<br> -URI http://asc.fasb.org/topic&amp;trid=2196928<br><br>Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef<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></p></div>
<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;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6756207056">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Fair Value Measurements<br></strong></div></th>
<th class="th" colspan="1">6 Months Ended</th>
</tr>
<tr><th class="th"><div>Jun. 30, 2018</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_FairValueDisclosuresAbstract', window );"><strong>Fair Value Disclosures [Abstract]</strong></a></td>
<td class="text">&#160;<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_FairValueDisclosuresTextBlock', window );">Fair Value Measurements</a></td>
<td class="text"><div>
 <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>3.</b></td>
 <td align="left" valign="top">
 <p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"><b>Fair Value Measurements:</b></p>
 </td>
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 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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 June&#xA0;30, 2018 and
 December&#xA0;31, 2017, the Company&#x2019;s money market funds had
 a carrying amount of $2.4&#xA0;million and $9.2&#xA0;million,
 respectively.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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 June&#xA0;30, 2018 and
 December&#xA0;31, 2017, the Company&#x2019;s cash surrender value of
 life insurance had a carrying amount of $15.7&#xA0;million and
 $15.6&#xA0;million, respectively.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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 June&#xA0;30, 2018 and
 December&#xA0;31, 2017, the Company&#x2019;s contingent
 consideration liabilities had a fair value of $30.7&#xA0;million
 and $30.5&#xA0;million, respectively.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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 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
 was measured at fair value, it would be categorized as Level&#xA0;2
 in the fair value hierarchy. The estimated fair value of the
 Company&#x2019;s 5.25% senior unsecured notes due 2023 was
 $735.0&#xA0;million and $763.1&#xA0;million, at June&#xA0;30, 2018
 and December&#xA0;31, 2017, respectively, and was estimated using
 trading prices on such dates as Level&#xA0;2 inputs to estimate
 fair value.</p>
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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 the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 820<br> -URI http://asc.fasb.org/topic&amp;trid=2155941<br></p></div>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6639474496">
<tr>
<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">6 Months Ended</th>
</tr>
<tr><th class="th"><div>Jun. 30, 2018</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_AccountsReceivableAndNetRevenueDisclosureTextBlock', window );">Accounts Receivable and Net Revenue</a></td>
<td class="text"><div>
 <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"><b>4.</b></td>
 <td valign="top" align="left">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 0pt" align="left"><b>Accounts Receivable and Net Revenue:</b></p>
 </td>
 </tr>
 </table>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; 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="68%"></td>
 <td valign="bottom" width="7%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="7%"></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="2" align="center"><b>June&#xA0;30, 2018</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>December&#xA0;31,&#xA0;2017</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 accounts receivable</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,918,787</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,790,034</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Allowance for contractual adjustments and uncollectibles</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(1,390,790</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(1,286,035</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">527,997</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</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>
 </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-LEFT: 4%; MARGIN-TOP: 12pt; TEXT-INDENT: 4%">
 Patient service revenue is recognized at the time services are
 provided by the Company&#x2019;s affiliated physicians. The
 Company&#x2019;s performance obligations related to the delivery of
 services to patients are satisfied at the time of service.
 Accordingly, there are no performance obligations that are
 unsatisfied or partially unsatisfied at the end of the reporting
 period with respect to patient service revenue. 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.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 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 third-party insurance payors for such services.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 Collection of patient service revenue the Company expects to
 receive is normally a function of providing complete and correct
 billing information to the government-sponsored healthcare programs
 and third-party insurance payors within the various filing
 deadlines and typically occurs
 within&#xA0;30&#xA0;to&#xA0;60&#xA0;days of billing.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 Some of the Company&#x2019;s hospital agreements require hospitals
 to pay the Company administrative fees. Some agreements provide for
 fees if the hospital does not generate sufficient patient volume in
 order to guarantee that the Company receives a specified minimum
 revenue level. The Company also receives fees from hospitals for
 administrative services performed by its affiliated physicians
 providing medical director or other services at the hospital.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 In addition, the Company generates revenue through its management
 services organization 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.</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The following table summarizes the Company&#x2019;s net revenue by
 category (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="60%"></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>
 <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;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"><b>Three Months Ended</b><br />
 <b>June&#xA0;30,</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>Six Months Ended</b><br />
 <b>June&#xA0;30,</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>2018</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>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>2018</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>2017</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 patient service revenue</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">763,667</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">708,739</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,520,040</td>
 <td valign="bottom" nowrap="nowrap"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,414,192</td>
 <td valign="bottom" nowrap="nowrap"></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">
 Hospital contract administrative fees</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">95,534</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">75,604</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">186,773</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">147,869</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">
 Management services and other</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">56,717</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">58,601</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">110,962</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">116,480</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">915,918</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">842,944</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,817,775</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,678,541</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: 0px; FONT-SIZE: 1px; MARGIN-TOP: 12px">
 &#xA0;</p>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 0pt; TEXT-INDENT: 4%">
 The approximate percentage of net patient service revenue by type
 of payor was 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="92%" align="center" border="0">
 <tr>
 <td width="72%"></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>
 <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="6" align="center">
 <b>Three&#xA0;Months&#xA0;Ended</b><br />
 <b>June&#xA0;30,</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"><b>Six&#xA0;Months&#xA0;Ended</b><br />
 <b>June&#xA0;30,</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>2018</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>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>2018</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>2017</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">
 Contracted managed care</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">70</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">71</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">70</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">71</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">
 Government</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">24</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">25</td>
 <td valign="bottom" nowrap="nowrap"></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">24</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">
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 Other third-parties</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4</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>
 <td valign="bottom" align="right">4</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
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 <font style="WHITE-SPACE: nowrap">Private-pay</font> patients</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
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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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 <td valign="bottom"></td>
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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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 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <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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 <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; 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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 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td valign="top"></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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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</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 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>
 <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">
 <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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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">
 <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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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Accounts receivable and net revenue 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>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6756914496">
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<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Business Acquisitions, Joint Ventures and Goodwill<br></strong></div></th>
<th class="th" colspan="1">6 Months Ended</th>
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<tr><th class="th"><div>Jun. 30, 2018</div></th></tr>
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<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_BusinessAcquisitionsJointVenturesAndGoodwillTextBlock', window );">Business Acquisitions, Joint Ventures and Goodwill</a></td>
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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="4%" valign="top" align="left"><b>5.</b></td>
 <td align="left" valign="top">
 <p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"><b>Business Acquisitions, Joint Ventures and
 Goodwill:</b></p>
 </td>
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 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 During the six months ended June&#xA0;30, 2018, the Company
 completed the acquisition of five physician group practices,
 including two radiology practices, one neonatology practice and two
 pediatric subspecialty practices. The acquisition-date fair value
 of the total consideration for the five acquisitions was
 $24.4&#xA0;million. These acquisitions expanded the Company&#x2019;s
 national network of physician practices. In connection with these
 acquisitions, the Company recorded goodwill of $15.5&#xA0;million
 and other intangible assets consisting primarily of physician and
 hospital agreements of $8.9 million.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 In addition, during the six months ended June&#xA0;30, 2018, in
 connection with certain prior-period acquisitions, the Company paid
 $0.4&#xA0;million for contingent consideration and
 $1.2&#xA0;million for purchase consideration that had been held
 back pending satisfaction of certain conditions. All amounts except
 for the accretion recorded during 2018 were accrued as of
 December&#xA0;31, 2017.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 In connection with certain prior-period acquisitions, the Company
 also recorded a decrease in current assets of $1.2&#xA0;million, a
 decrease in noncurrent assets of $1.5&#xA0;million, an increase in
 current liabilities of $1.4&#xA0;million and an increase in
 noncurrent liabilities of $1.2&#xA0;million, with a corresponding
 net increase in goodwill of $5.3&#xA0;million for
 measurement-period adjustments resulting from the finalization of
 acquisition accounting. The Company expects that $18.2&#xA0;million
 of the goodwill recorded during the six months ended June&#xA0;30,
 2018 will be deductible for tax purposes.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 In January 2018, the Company completed the sale of a controlling
 interest and the contribution of remaining assets to a joint
 venture related to the $46.0&#xA0;million of assets held for sale
 at December&#xA0;31, 2017. The Company accounts for its 49.0%
 economic interest in the joint venture as an equity method
 investment. The investment in this joint venture is included in
 other assets as presented in the Company&#x2019;s Condensed
 Consolidated Balance Sheet.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 The Company&#x2019;s management services reporting unit has
 experienced lower operating results than previously forecasted
 primarily due to a slower rate of new customer bookings and an
 increase in customer termination activity. The Company continues to
 believe that the fair value of the reporting unit exceeds the
 carrying value, and accordingly the goodwill assigned to the
 management services reporting unit is not impaired&#xA0;Although
 the Company believes that the current assumptions and estimates
 used in its goodwill analysis are reasonable, supportable and
 appropriate, continued efforts to maintain or improve the
 performance of this business could be impacted by unfavorable or
 unforeseen changes which could impact the existing assumptions used
 in the impairment analysis. Various factors could reasonably be
 expected to unfavorably impact existing assumptions, primarily
 delays in new customer bookings and the related delay in revenue
 from new customers, increases in customer termination activity or
 increases in operating costs. Accordingly, there can be no
 assurance that the estimates and assumptions made for the purposes
 of the goodwill impairment analysis will prove to be accurate
 predictions of future performance. The carrying value of the
 Company&#x2019;s management services reporting unit included
 goodwill of $321.6&#xA0;million as of June&#xA0;30, 2018. The
 Company will continue to closely monitor the performance of the
 management services reporting unit. If an impairment loss is
 required in a future period, it could have a material adverse
 effect on the Company&#x2019;s business, financial condition,
 results of operations, cash flows and the trading price of the
 Company&#x2019;s securities.</p>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Business acquisitions joint ventures and goodwill.</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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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6634791184">
<tr>
<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">6 Months Ended</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_PayablesAndAccrualsAbstract', window );"><strong>Payables and Accruals [Abstract]</strong></a></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_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock', window );">Accounts Payable and Accrued Expenses</a></td>
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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="4%" valign="top" align="left"><b>6.</b></td>
 <td align="left" valign="top">
 <p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"><b>Accounts Payable and Accrued Expenses:</b></p>
 </td>
 </tr>
 </table>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 Accounts payable and accrued expenses consist of the following (in
 thousands):</p>
 <p style="font-size:12pt;margin-top:0pt;margin-bottom:0pt">
 &#xA0;</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="68%"></td>
 <td valign="bottom" width="9%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="9%"></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">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000">
 <b>June&#xA0;30,&#xA0;2018</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000">
 <b>December&#xA0;31,&#xA0;2017</b></td>
 <td valign="bottom">&#xA0;</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">
 Accounts payable</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">28,377</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
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 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
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 <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">
 Accrued salaries and bonuses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">144,911</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">225,429</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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">
 Accrued payroll taxes and benefits</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">71,379</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">75,672</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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">
 Accrued professional liabilities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35,253</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">37,912</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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">
 Accrued contingent consideration</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,783</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6,259</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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">
 Accrued interest</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">5,077</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4,495</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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 accrued expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">46,475</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">53,618</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 </tr>
 <tr style="font-size:1px;">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">358,255</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">438,017</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 </tr>
 <tr style="font-size:1px;">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 </table>
 <p style="margin-top:12pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 The net decrease in accrued salaries and bonuses of
 $80.5&#xA0;million from December&#xA0;31, 2017 to June&#xA0;30,
 2018 is primarily due to the payment of performance-based incentive
 compensation, principally to the Company&#x2019;s physicians,
 partially offset by performance-based incentive compensation
 accrued during the six months ended June&#xA0;30, 2018. A majority
 of the Company&#x2019;s payments for performance-based incentive
 compensation is paid annually during the first quarter.</p>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6629467632">
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<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">6 Months Ended</th>
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 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 The calculation of shares used in the basic and diluted net income
 per common share calculation for the three and six months ended
 June&#xA0;30, 2018 and 2017 is as follows (in thousands):</p>
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 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="2%"></td>
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 <tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="6" align="center" style="border-bottom:1.00pt solid #000000"><b>Six Months Ended</b><br />
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 <td valign="bottom">&#xA0;</td>
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 <tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"><b>2018</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"><b>2017</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"><b>2018</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
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 <td valign="bottom">&#xA0;</td>
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 <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">
 Weighted average number of common shares outstanding</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,987</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,181</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,922</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,270</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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">
 Weighted average number of dilutive common share equivalents</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">542</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">631</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">594</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">707</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 </tr>
 <tr style="font-size:1px;">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</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">
 Weighted average number of common and common equivalent shares
 outstanding</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,529</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,812</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,516</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,977</td>
 <td nowrap="nowrap" valign="bottom">&#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-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</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">
 Antidilutive securities not included in the diluted net income per
 common share calculation</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">392</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">8</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">197</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">5</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 </tr>
 <tr style="font-size:1px;">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<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;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6632008976">
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<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">6 Months Ended</th>
</tr>
<tr><th class="th"><div>Jun. 30, 2018</div></th></tr>
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<td class="text">&#160;<span></span>
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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%">
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 <td width="4%" valign="top" align="left"><b>8.</b></td>
 <td align="left" valign="top">
 <p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"><b>Stock Incentive Plans and Stock Purchase
 Plans:</b></p>
 </td>
 </tr>
 </table>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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 and service-based conditions. The
 Company recognizes compensation expense related to its restricted
 stock and deferred stock awards ratably over the corresponding
 vesting periods. During the six months ended June&#xA0;30, 2018,
 the Company granted 597,550 shares of restricted stock to its
 employees and <font style="white-space:nowrap">non-employee</font>
 directors under the Amended and Restated 2008 Incentive Plan. At
 June&#xA0;30, 2018, the Company had 2.3&#xA0;million shares
 available for future grants and awards under its Amended and
 Restated 2008 Incentive Plan.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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 <font style="white-space:nowrap">non-employee</font> 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.</p>
 <p style="font-size:1px;margin-top:6px;margin-bottom:0px">
 &#xA0;</p>
 <p style="margin-top:0pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 Each of the ESPP and the SPP provide for the issuance of an
 aggregate of 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 six months ended June&#xA0;30, 2018, 182,888
 shares in aggregate were issued under the ESPP and SPP. At
 June&#xA0;30, 2018, the Company had approximately 1.8&#xA0;million
 shares in aggregate reserved for issuance under the ESPP and
 SPP.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 During the three and six months ended June&#xA0;30, 2018 and 2017,
 the Company recognized stock-based compensation expense of
 $10.5&#xA0;million and $20.4&#xA0;million, and $7.3&#xA0;million
 and $14.8&#xA0;million, respectively.</p>
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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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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>
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<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Common Stock Repurchase Program<br></strong></div></th>
<th class="th" colspan="1">6 Months Ended</th>
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<tr><th class="th"><div>Jun. 30, 2018</div></th></tr>
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<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 Program</a></td>
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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%">
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 <td width="4%" valign="top" align="left"><b>9.</b></td>
 <td align="left" valign="top">
 <p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"><b>Common Stock Repurchase Program:</b></p>
 </td>
 </tr>
 </table>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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. During the six months ended June&#xA0;30,
 2018, the Company repurchased 1.2&#xA0;million shares of its common
 stock for $52.2&#xA0;million, inclusive of 54,909 shares withheld
 to satisfy minimum statutory withholding obligations of
 $2.5&#xA0;million in connection with the vesting of restricted
 stock and stock option exercises during the three months ended
 June&#xA0;30, 2018. The shares repurchased by the Company during
 the second quarter of 2018 completed the repurchases under the
 program with respect to issuances of shares under the
 Company&#x2019;s equity compensation programs during 2018. 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.</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>
<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;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6756209520">
<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">6 Months Ended</th>
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<td class="text">&#160;<span></span>
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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="4%" valign="top" align="left"><b>10.</b></td>
 <td align="left" valign="top">
 <p style="margin-top:0pt ; margin-bottom:0pt; font-size:10pt; font-family:Times New Roman;" align="left"><b>Commitments and Contingencies:</b></p>
 </td>
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 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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 securities. The Company has not included an
 accrual for these matters as of June&#xA0;30, 2018 in its Condensed
 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.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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.</p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; 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&#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.</p>
 </div><span></span>
</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">
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>The entire disclosure for commitments and contingencies.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 450<br> -URI http://asc.fasb.org/topic&amp;trid=2127136<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 440<br> -URI http://asc.fasb.org/topic&amp;trid=2144648<br></p></div>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6630490128">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Basis of Presentation and New Accounting Pronouncements (Policies)<br></strong></div></th>
<th class="th" colspan="1">6 Months Ended</th>
</tr>
<tr><th class="th"><div>Jun. 30, 2018</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 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-top:18pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">
 <b>Recently Adopted Accounting Pronouncements</b></p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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. The guidance became effective
 for the Company on January&#xA0;1, 2018 and was adopted on a full
 retrospective basis. 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, 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 did not have
 an impact on our Consolidated Financial Statements, other than
 increased financial statement disclosures. The guidance requires
 increased disclosures, including qualitative and quantitative
 disclosures about the nature, amount, timing and uncertainty of
 revenue and cash flows arising from contracts with customers. See
 Note 4 for more information.</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_NewAccountingPronouncementsPolicyPolicyTextBlock', window );">New Accounting Pronouncements</a></td>
<td class="text"><div>
 <p style="margin-top:18pt; margin-bottom:0pt; margin-left:4%; font-size:10pt; font-family:Times New Roman">
 <b>New Accounting Pronouncements</b></p>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 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 has completed the review of its existing lease
 portfolio and is accumulating all of the necessary information
 required to properly account for leases under the new guidance. The
 Company has selected a software application, inclusive of a lease
 administration module and an accounting module, and has begun the
 implementation process. The Company is in the process of designing
 workflows, business processes and internal controls surrounding the
 lease accounting process in order to meet the reporting and
 disclosure requirements. The Company&#x2019;s implementation and
 continued evaluation of this new guidance and its impacts are
 expected to continue through the third quarter of 2018.</p>
 </div><span></span>
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</tr>
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<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">
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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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<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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<html>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6756189104">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Cash Equivalents and Investments (Tables)<br></strong></div></th>
<th class="th" colspan="1">6 Months Ended</th>
</tr>
<tr><th class="th"><div>Jun. 30, 2018</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-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 Investments held at June&#xA0;30, 2018 and December&#xA0;31, 2017
 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="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>
 <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="6" align="center"><b>June&#xA0;30, 2018</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, 2017</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">8,432</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">48,613</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</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>
 </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" 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">36,393</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,000</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>
 </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">1,470</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">5,180</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">4,165</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">9,902</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">90,186</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</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>
 </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>
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</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-LEFT: 4%; 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="68%"></td>
 <td valign="bottom" width="10%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="10%"></td>
 <td></td>
 <td></td>
 <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="2" align="center"><b>June&#xA0;30,&#xA0;2018</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>December&#xA0;31,&#xA0;2017</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">89,186</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">78,561</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Due after five years through six years</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1,000</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">2,121</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">90,186</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>
 </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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</td>
</tr>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of information about investment in debt security measured at amortized cost (held-to-maturity).</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<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></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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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6633775440">
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<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">6 Months Ended</th>
</tr>
<tr><th class="th"><div>Jun. 30, 2018</div></th></tr>
<tr class="re">
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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_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-LEFT: 4%; 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">
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 <td width="68%"></td>
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 <td valign="bottom" width="7%"></td>
 <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="2" align="center"><b>June&#xA0;30, 2018</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>December&#xA0;31,&#xA0;2017</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 accounts receivable</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,918,787</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,790,034</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid">
 <td valign="top">
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 1em; MARGIN-TOP: 0pt; TEXT-INDENT: -1em">
 Allowance for contractual adjustments and uncollectibles</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(1,390,790</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">(1,286,035</td>
 <td valign="bottom" nowrap="nowrap">)&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 1px">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 1px solid; MARGIN-TOP: 0pt">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; PAGE-BREAK-INSIDE: avoid" bgcolor="#CCEEFF">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">527,997</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</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>
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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 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>
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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_DisaggregationOfRevenueTableTextBlock', window );">Schedule of Net Revenue</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 6pt; TEXT-INDENT: 4%">
 The following table summarizes the Company&#x2019;s net revenue by
 category (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="60%"></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>
 <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;&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"><b>Three Months Ended</b><br />
 <b>June&#xA0;30,</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>Six Months Ended</b><br />
 <b>June&#xA0;30,</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>2018</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>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>2018</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>2017</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 patient service revenue</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">763,667</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">708,739</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,520,040</td>
 <td valign="bottom" nowrap="nowrap"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">1,414,192</td>
 <td valign="bottom" nowrap="nowrap"></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">
 Hospital contract administrative fees</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">95,534</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">75,604</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">186,773</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">147,869</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">
 Management services and other</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">56,717</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">58,601</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">110,962</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">116,480</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>
 <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>
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 <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">915,918</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">842,944</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
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 <td valign="bottom">&#xA0;&#xA0;</td>
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 <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>
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 <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>
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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;&#xA0;</td>
 <td valign="bottom">
 <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 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 Percentage of Net Patient Service Revenue</a></td>
<td class="text"><div>
 <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-LEFT: 4%; MARGIN-TOP: 0pt; TEXT-INDENT: 4%">
 The approximate percentage of net patient service revenue by type
 of payor was 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="92%" align="center" border="0">
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 <td width="72%"></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>
 <td valign="bottom" width="5%"></td>
 <td></td>
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 <td valign="bottom">&#xA0;</td>
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 <b>Three&#xA0;Months&#xA0;Ended</b><br />
 <b>June&#xA0;30,</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td style="BORDER-BOTTOM: #000000 1pt solid" valign="bottom" colspan="6" align="center"><b>Six&#xA0;Months&#xA0;Ended</b><br />
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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="2" align="center"><b>2018</b></td>
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 <td valign="bottom">&#xA0;</td>
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 Contracted managed care</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">70</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">71</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">70</td>
 <td valign="bottom" nowrap="nowrap">%&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
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 Government</p>
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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>
 <td valign="bottom">&#xA0;</td>
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 Other third-parties</p>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</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">
 <font style="WHITE-SPACE: nowrap">Private-pay</font> patients</p>
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 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">1</td>
 <td valign="bottom" nowrap="nowrap">&#xA0;</td>
 <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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 <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>
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 <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>&#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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 <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">&#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>
 <td valign="bottom" align="right">100</td>
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 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">100</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 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>
 <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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 <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>
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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>
 <td valign="bottom">&#xA0;</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">
 <p style="MARGIN-BOTTOM: 0pt; BORDER-TOP: #000000 3px double; MARGIN-TOP: 0pt">
 &#xA0;</p>
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 <td>&#xA0;</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Tabular disclosure of disaggregation of revenue into categories depicting how nature, amount, timing, and uncertainty of revenue and cash flows are affected by economic factor.</p></div>
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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>
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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>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6609409440">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accounts Payable and Accrued Expenses (Tables)<br></strong></div></th>
<th class="th" colspan="1">6 Months Ended</th>
</tr>
<tr><th class="th"><div>Jun. 30, 2018</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>
</tr>
<tr 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_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock', window );">Schedule of Accounts Payable and Accrued Expenses</a></td>
<td class="text"><div>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 Accounts payable and accrued expenses consist of the following (in
 thousands):</p>
 <p style="font-size:12pt;margin-top:0pt;margin-bottom:0pt">
 &#xA0;</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="68%"></td>
 <td valign="bottom" width="9%"></td>
 <td></td>
 <td></td>
 <td></td>
 <td valign="bottom" width="9%"></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">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000">
 <b>June&#xA0;30,&#xA0;2018</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000">
 <b>December&#xA0;31,&#xA0;2017</b></td>
 <td valign="bottom">&#xA0;</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">
 Accounts payable</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">28,377</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">34,632</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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">
 Accrued salaries and bonuses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">144,911</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">225,429</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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">
 Accrued payroll taxes and benefits</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">71,379</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">75,672</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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">
 Accrued professional liabilities</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">35,253</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">37,912</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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">
 Accrued contingent consideration</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">26,783</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">6,259</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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">
 Accrued interest</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">5,077</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">4,495</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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 accrued expenses</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">46,475</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">53,618</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 </tr>
 <tr style="font-size:1px;">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 </tr>
 <tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:10pt">
 <td valign="top"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">358,255</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">$</td>
 <td valign="bottom" align="right">438,017</td>
 <td nowrap="nowrap" valign="bottom">&#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-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
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 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
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 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#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">
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<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_PayablesAndAccrualsAbstract</td>
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<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 );">- 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>
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<td style="white-space:nowrap;">us-gaap_ScheduleOfAccountsPayableAndAccruedLiabilitiesTableTextBlock</td>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6634752768">
<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">6 Months Ended</th>
</tr>
<tr><th class="th"><div>Jun. 30, 2018</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>
</tr>
<tr 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_ScheduleOfWeightedAverageNumberOfSharesTableTextBlock', window );">Schedule of Calculation of Shares Used in Basic and Diluted Net Income Per Share</a></td>
<td class="text"><div>
 <p style="margin-top:6pt; margin-bottom:0pt; margin-left:4%; text-indent:4%; font-size:10pt; font-family:Times New Roman">
 The calculation of shares used in the basic and diluted net income
 per common share calculation for the three and six months ended
 June&#xA0;30, 2018 and 2017 is as follows (in thousands):</p>
 <p style="font-size:12pt;margin-top:0pt;margin-bottom:0pt">
 &#xA0;</p>
 <table cellspacing="0" cellpadding="0" width="92%" border="0" style="BORDER-COLLAPSE:COLLAPSE; font-family:Times New Roman; font-size:10pt" align="center">
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 <td width="72%"></td>
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 <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>
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 <td></td>
 <td valign="bottom" width="2%"></td>
 <td></td>
 <td></td>
 <td></td>
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 <tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
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 <b>Three&#xA0;Months&#xA0;Ended</b><br />
 <b>June&#xA0;30,</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="6" align="center" style="border-bottom:1.00pt solid #000000"><b>Six Months Ended</b><br />
 <b>June&#xA0;30,</b></td>
 <td valign="bottom">&#xA0;</td>
 </tr>
 <tr style="page-break-inside:avoid ; font-family:Times New Roman; font-size:8pt">
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"><b>2018</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"><b>2017</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"><b>2018</b></td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom" colspan="2" align="center" style="border-bottom:1.00pt solid #000000"><b>2017</b></td>
 <td valign="bottom">&#xA0;</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">
 Weighted average number of common shares outstanding</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,987</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,181</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,922</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,270</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</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">
 Weighted average number of dilutive common share equivalents</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">542</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">631</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">594</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">707</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 </tr>
 <tr style="font-size:1px;">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:1.00px solid #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
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 <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">
 Weighted average number of common and common equivalent shares
 outstanding</p>
 </td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,529</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,812</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">93,516</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">&#xA0;</td>
 <td valign="bottom" align="right">92,977</td>
 <td nowrap="nowrap" valign="bottom">&#xA0;</td>
 </tr>
 <tr style="font-size:1px;">
 <td valign="bottom"></td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td valign="bottom">
 <p style=" margin-top:0pt ; margin-bottom:0pt; border-top:3.00px double #000000">
 &#xA0;</p>
 </td>
 <td>&#xA0;</td>
 <td valign="bottom">&#xA0;&#xA0;</td>
 <td valign="bottom">
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 Antidilutive securities not included in the diluted net income per
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<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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<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Jan. 31, 2018</div></th>
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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 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 style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<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=114001798&amp;loc=d3e33918-111571<br></p></div>
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<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Cash Equivalents and Investments - Additional Information (Detail) - USD ($)<br> $ in Millions</strong></div></th>
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<td class="text">&#160;<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 );">- Definition</a><div><p>Cash equivalents and 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>
<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 );">+ 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>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_us-gaap_MoneyMarketFundsAtCarryingValue">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Investment in short-term money-market instruments (such as commercial paper, banker's acceptances, repurchase agreements, government securities, certificates of deposit, and so forth) which are highly liquid (that is, readily convertible to known amounts of cash) and so near their maturity that they present an insignificant risk of changes in value because of changes in interest rates. Generally, only investments with original maturities of three months or less qualify as cash equivalents by definition. Original maturity means an original maturity to the entity holding the investment. For example, both a three-month US Treasury bill and a three-year Treasury note purchased three months from maturity qualify as cash equivalents. However, a Treasury note purchased three-years ago does not become a cash equivalent when its remaining maturity is three months.</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_MoneyMarketFundsAtCarryingValue</td>
</tr>
<tr>
<td style="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_CashAndCashEquivalentsAxis=us-gaap_CashEquivalentsMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_CashAndCashEquivalentsAxis=us-gaap_CashEquivalentsMember</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_srt_RangeAxis=srt_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;">srt_RangeAxis=srt_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>
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<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_srt_RangeAxis=srt_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;">srt_RangeAxis=srt_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>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
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</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>33
<FILENAME>R23.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;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6765596880">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Cash Equivalents and Investments - Schedule of Investments (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<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_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">$ 9,902<span></span>
</td>
<td class="nump">$ 10,292<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">90,186<span></span>
</td>
<td class="nump">80,682<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">8,432<span></span>
</td>
<td class="nump">8,312<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">48,613<span></span>
</td>
<td class="nump">46,195<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="text">&#160;<span></span>
</td>
<td class="nump">1,000<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_HeldToMaturitySecuritiesNoncurrent', window );">Long-Term</a></td>
<td class="nump">36,393<span></span>
</td>
<td class="nump">30,322<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">1,470<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">$ 5,180<span></span>
</td>
<td class="nump">$ 4,165<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 of investment in debt security measured at amortized cost (held-to-maturity), classified as current.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<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=109979856&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_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 of investment in debt security measured at amortized cost (held-to-maturity), 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://fasb.org/us-gaap/role/ref/legacyRef<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=109979856&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_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>
</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_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>
<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_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>
</tr>
<tr>
<td><strong> Period Type:</strong></td>
<td></td>
</tr>
</table></div>
</div></td></tr>
</table>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>34
<FILENAME>R24.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;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6630372960">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Cash Equivalents and Investments - Schedule of Contractual Maturities of Long-Term Investments (Detail) - USD ($)<br> $ in Thousands</strong></div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<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>
<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">$ 89,186<span></span>
</td>
<td class="nump">$ 78,561<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">1,000<span></span>
</td>
<td class="nump">2,121<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">$ 90,186<span></span>
</td>
<td class="nump">$ 80,682<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>Amount of investment in debt security measured at amortized cost (held-to-maturity), with single maturity date and allocated without single maturity date, maturing in sixth through tenth fiscal year following latest fiscal year. Excludes interim and annual periods when interim period is reported on rolling approach, from latest statement of financial position date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of investment in debt security measured at amortized cost (held-to-maturity), with single maturity date and allocated without single maturity date, maturing in next fiscal year through fifth fiscal year following latest fiscal year. Excludes interim and annual periods when interim period is reported on rolling approach, from latest statement of financial position date.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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 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><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of investment in debt security measured at amortized cost (held-to-maturity), 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://fasb.org/us-gaap/role/ref/legacyRef<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=109979856&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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<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;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6755219216">
<tr>
<th class="tl" colspan="1" rowspan="1"><div style="width: 200px;"><strong>Fair Value Measurements - Additional Information (Detail) - USD ($)<br> $ in Millions</strong></div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<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_md_FairValueMeasurementsDisclosureLineItems', window );"><strong>Fair Value Measurements Disclosure [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_MoneyMarketFundsAtCarryingValue', window );">Money market funds carrying amount</a></td>
<td class="nump">$ 2.4<span></span>
</td>
<td class="nump">$ 9.2<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_CashSurrenderValueOfLifeInsurance', window );">Carrying amount of cash surrender value of life insurance</a></td>
<td class="nump">15.7<span></span>
</td>
<td class="nump">15.6<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_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized', window );">Contingent consideration liabilities related to acquisitions</a></td>
<td class="nump">30.7<span></span>
</td>
<td class="nump">30.5<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_md_FairValueMeasurementsDisclosureLineItems', window );"><strong>Fair Value Measurements Disclosure [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_NotesPayableFairValueDisclosure', window );">Estimated fair value of notes</a></td>
<td class="nump">$ 735.0<span></span>
</td>
<td class="nump">$ 763.1<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="nump">5.25%<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_md_FairValueMeasurementsDisclosureLineItems">
<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>Fair Value Measurements Disclosure [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>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized">
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<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://fasb.org/us-gaap/role/ref/legacyRef<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>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_CashSurrenderValueOfLifeInsurance">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 amounts which could be received based on the terms of the insurance contract upon surrendering life policies owned 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://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 210<br> -SubTopic 10<br> -Section 45<br> -Paragraph 4<br> -Subparagraph (d)<br> -URI http://asc.fasb.org/extlink&amp;oid=82887183&amp;loc=d3e6812-107765<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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_CashSurrenderValueOfLifeInsurance</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_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://fasb.org/us-gaap/role/ref/legacyRef<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>
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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>Investment in short-term money-market instruments (such as commercial paper, banker's acceptances, repurchase agreements, government securities, certificates of deposit, and so forth) which are highly liquid (that is, readily convertible to known amounts of cash) and so near their maturity that they present an insignificant risk of changes in value because of changes in interest rates. Generally, only investments with original maturities of three months or less qualify as cash equivalents by definition. Original maturity means an original maturity to the entity holding the investment. For example, both a three-month US Treasury bill and a three-year Treasury note purchased three months from maturity qualify as cash equivalents. However, a Treasury note purchased three-years ago does not become a cash equivalent when its remaining maturity is three months.</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_MoneyMarketFundsAtCarryingValue</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>debit</td>
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<tr>
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<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://fasb.org/us-gaap/role/ref/legacyRef<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>
</tr>
<tr>
<td style="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_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>
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</div>
</body>
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<DOCUMENT>
<TYPE>XML
<SEQUENCE>36
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<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;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6756161248">
<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>Jun. 30, 2018</div></th>
<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_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">$ 1,918,787<span></span>
</td>
<td class="nump">$ 1,790,034<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">(1,390,790)<span></span>
</td>
<td class="num">(1,286,035)<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">$ 527,997<span></span>
</td>
<td class="nump">$ 503,999<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">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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>
<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_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/disclosureRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 606<br> -SubTopic 10<br> -Section 50<br> -Paragraph 8<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=109196051&amp;loc=SL49130549-203045<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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_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://fasb.org/us-gaap/role/ref/legacyRef<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><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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_AllowanceForDoubtfulAccountsReceivableCurrent</td>
</tr>
<tr>
<td style="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_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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<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>
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</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>37
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<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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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6763014928">
<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="2">3 Months Ended</th>
<th class="th" colspan="2">6 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
</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_srt_ProductOrServiceAxis=us-gaap_HealthCarePatientServiceMember', window );">Net patient service 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>
</tr>
<tr 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_DisaggregationOfRevenueAbstract', window );"><strong>Disaggregation of Revenue [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="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax', window );">Net revenue</a></td>
<td class="nump">$ 763,667<span></span>
</td>
<td class="nump">$ 708,739<span></span>
</td>
<td class="nump">$ 1,520,040<span></span>
</td>
<td class="nump">$ 1,414,192<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_srt_ProductOrServiceAxis=md_HospitalsContractsMember', 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>
</tr>
<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_DisaggregationOfRevenueAbstract', window );"><strong>Disaggregation of Revenue [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_RevenueFromContractWithCustomerIncludingAssessedTax', window );">Net revenue</a></td>
<td class="nump">95,534<span></span>
</td>
<td class="nump">75,604<span></span>
</td>
<td class="nump">186,773<span></span>
</td>
<td class="nump">147,869<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_srt_ProductOrServiceAxis=us-gaap_ManagementServiceMember', window );">Management services and other</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_DisaggregationOfRevenueAbstract', window );"><strong>Disaggregation of Revenue [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="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax', window );">Net revenue</a></td>
<td class="nump">56,717<span></span>
</td>
<td class="nump">58,601<span></span>
</td>
<td class="nump">110,962<span></span>
</td>
<td class="nump">116,480<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_srt_ProductOrServiceAxis=us-gaap_HealthCareMember', window );">Health Care</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_DisaggregationOfRevenueAbstract', window );"><strong>Disaggregation of Revenue [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_RevenueFromContractWithCustomerIncludingAssessedTax', window );">Net revenue</a></td>
<td class="nump">$ 915,918<span></span>
</td>
<td class="nump">$ 842,944<span></span>
</td>
<td class="nump">$ 1,817,775<span></span>
</td>
<td class="nump">$ 1,678,541<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_DisaggregationOfRevenueAbstract">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_DisaggregationOfRevenueAbstract</td>
</tr>
<tr>
<td style="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_RevenueFromContractWithCustomerIncludingAssessedTax">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 606<br> -SubTopic 10<br> -Section 50<br> -Paragraph 1<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=109196051&amp;loc=SL49130539-203045<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 606<br> -SubTopic 10<br> -Section 50<br> -Paragraph 5<br> -URI http://asc.fasb.org/extlink&amp;oid=109196051&amp;loc=SL49130545-203045<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<br> -Publisher FASB<br> -Name Accounting Standards Codification<br> -Topic 606<br> -SubTopic 10<br> -Section 50<br> -Paragraph 4<br> -Subparagraph (a)<br> -URI http://asc.fasb.org/extlink&amp;oid=109196051&amp;loc=SL49130543-203045<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><div style="display: none;"><table border="0" cellpadding="0" cellspacing="0">
<tr>
<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_RevenueFromContractWithCustomerIncludingAssessedTax</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>
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<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;">srt_ProductOrServiceAxis=md_HospitalsContractsMember</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;">srt_ProductOrServiceAxis=us-gaap_ManagementServiceMember</td>
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<html>
<head>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6763019104">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accounts Receivable and Net Revenue - Schedule of Net Patient Service Revenue by Type of Payor (Detail)<br></strong></div></th>
<th class="th" colspan="2">3 Months Ended</th>
<th class="th" colspan="2">6 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 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_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems', window );"><strong>Health Care Organization, Receivable and Revenue Disclosures [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>
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<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_PercentageOfNetPatientServiceRevenueByTypeOfPayor', window );">Percentage of net patient service revenue</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>
<td class="nump">100.00%<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_HealthCareOrganizationRevenueSourcesAxis=md_ContractedManagedCareMember', window );">Contracted Managed Care [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_us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems', window );"><strong>Health Care Organization, Receivable and Revenue Disclosures [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_PercentageOfNetPatientServiceRevenueByTypeOfPayor', window );">Percentage of net patient service revenue</a></td>
<td class="nump">70.00%<span></span>
</td>
<td class="nump">71.00%<span></span>
</td>
<td class="nump">70.00%<span></span>
</td>
<td class="nump">71.00%<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_HealthCareOrganizationRevenueSourcesAxis=us-gaap_GovernmentMember', window );">Government [Member]</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>
</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_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems', window );"><strong>Health Care Organization, Receivable and Revenue Disclosures [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_PercentageOfNetPatientServiceRevenueByTypeOfPayor', window );">Percentage of net patient service revenue</a></td>
<td class="nump">25.00%<span></span>
</td>
<td class="nump">24.00%<span></span>
</td>
<td class="nump">25.00%<span></span>
</td>
<td class="nump">24.00%<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_HealthCareOrganizationRevenueSourcesAxis=us-gaap_ThirdPartyPayorMember', window );">Other Third-Parties [Member]</a></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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<tr 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_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems', window );"><strong>Health Care Organization, Receivable and Revenue Disclosures [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>
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<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_PercentageOfNetPatientServiceRevenueByTypeOfPayor', window );">Percentage of net patient service revenue</a></td>
<td class="nump">4.00%<span></span>
</td>
<td class="nump">4.00%<span></span>
</td>
<td class="nump">4.00%<span></span>
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<td class="nump">4.00%<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_HealthCareOrganizationRevenueSourcesAxis=us-gaap_SelfPayMember', window );">Private-Pay Patients [Member]</a></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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<tr class="re">
<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems', window );"><strong>Health Care Organization, Receivable and Revenue Disclosures [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_PercentageOfNetPatientServiceRevenueByTypeOfPayor', window );">Percentage of net patient service revenue</a></td>
<td class="nump">1.00%<span></span>
</td>
<td class="nump">1.00%<span></span>
</td>
<td class="nump">1.00%<span></span>
</td>
<td class="nump">1.00%<span></span>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Percentage of net patient service revenue by type payor.</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_PercentageOfNetPatientServiceRevenueByTypeOfPayor</td>
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<td>num:percentItemType</td>
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<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_HealthCareOrganizationReceivableAndRevenueDisclosuresLineItems</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>
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<td><strong> Name:</strong></td>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6763180480">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Business Acquisitions, Joint Ventures and Goodwill - Additional Information (Detail)<br> $ in Thousands</strong></div></th>
<th class="th" colspan="1">6 Months Ended</th>
<th class="th" colspan="1"></th>
</tr>
<tr>
<th class="th">
<div>Jun. 30, 2018 </div>
<div>USD ($) </div>
<div>Company</div>
</th>
<th class="th">
<div>Dec. 31, 2017 </div>
<div>USD ($)</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_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="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="nump">5<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_NumberOfNeonatologyPracticesAcquired', window );">Number of neonatology practices acquired | Company</a></td>
<td class="nump">1<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_NumberOfPediatricSubspecialtyPracticesAcquired', window );">Number of other pediatric subspecialty practices acquired | Company</a></td>
<td class="nump">2<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="nump">2<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</a></td>
<td class="nump">$ 24,400<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_Goodwill', window );">Goodwill</a></td>
<td class="nump">4,304,740<span></span>
</td>
<td class="nump">$ 4,283,963<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_PaymentsForPreviousAcquisition', window );">Contingent consideration payments related to prior-period acquisitions</a></td>
<td class="nump">400<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_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions', window );">Purchase consideration payments related to prior-period acquisitions</a></td>
<td class="nump">1,200<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_AssetsHeldForSaleNotPartOfDisposalGroup', window );">Assets held for sale</a></td>
<td class="nump">$ 46,000<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_EquityMethodInvestmentOwnershipPercentage', window );">Sale of equity method investments</a></td>
<td class="nump">49.00%<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_StatementBusinessSegmentsAxis=md_ManagementServicesReportingUnitMember', window );">Management Services Reporting Unit [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_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="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">$ 321,600<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_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_Goodwill', window );">Goodwill</a></td>
<td class="nump">15,500<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_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles', window );">Other intangible assets</a></td>
<td class="nump">8,900<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>
</tr>
<tr 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 );">Decrease in current assets</a></td>
<td class="nump">1,200<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_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets', window );">Decrease in noncurrent assets</a></td>
<td class="nump">1,500<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_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentLiabilities', window );">Decrease in current liabilities</a></td>
<td class="nump">1,400<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_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities', window );">Increase in noncurrent liabilities</a></td>
<td class="nump">1,200<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 );">Net increase in goodwill resulting from finalization of tax acquisition accounting</a></td>
<td class="nump">5,300<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 purposes</a></td>
<td class="nump">$ 18,200<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_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_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_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Payment For Purchase Consideration Related To Prior Period Acquisitions</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_PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions</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_AssetsHeldForSaleNotPartOfDisposalGroup">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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.</p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ References</a><div style="display: none;"><p>Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef<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_AssetsHeldForSaleNotPartOfDisposalGroup</td>
</tr>
<tr>
<td style="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_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_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://fasb.org/us-gaap/role/ref/legacyRef<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>
</tr>
<tr>
<td style="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_BusinessCombinationConsiderationTransferred1">
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<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://fasb.org/us-gaap/role/ref/legacyRef<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=109124213&amp;loc=d3e6613-128477<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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=109124213&amp;loc=d3e6578-128477<br></p></div>
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<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://fasb.org/us-gaap/role/ref/legacyRef<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>
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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://fasb.org/us-gaap/role/ref/legacyRef<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">
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<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://fasb.org/us-gaap/role/ref/legacyRef<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=108330185&amp;loc=d3e2207-128464<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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">
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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 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://fasb.org/us-gaap/role/ref/legacyRef<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">
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<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentAssets</td>
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<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Amount of 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://fasb.org/us-gaap/role/ref/legacyRef<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">
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<td><strong> Name:</strong></td>
<td style="white-space:nowrap;">us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilities</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 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://fasb.org/us-gaap/role/ref/legacyRef<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=114001798&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>
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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 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://fasb.org/us-gaap/role/ref/legacyRef<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><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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=99380562&amp;loc=d3e13770-109266<br></p></div>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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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<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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=108376223&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>
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<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>Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef<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=109223946&amp;loc=d3e3213-108585<br></p></div>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6755426656">
<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>Jun. 30, 2018</div></th>
<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_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">$ 28,377<span></span>
</td>
<td class="nump">$ 34,632<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">144,911<span></span>
</td>
<td class="nump">225,429<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">71,379<span></span>
</td>
<td class="nump">75,672<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">35,253<span></span>
</td>
<td class="nump">37,912<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">26,783<span></span>
</td>
<td class="nump">6,259<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_InterestPayableCurrent', window );">Accrued interest</a></td>
<td class="nump">5,077<span></span>
</td>
<td class="nump">4,495<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">46,475<span></span>
</td>
<td class="nump">53,618<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">$ 358,255<span></span>
</td>
<td class="nump">$ 438,017<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>
</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_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>
</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_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://fasb.org/us-gaap/role/ref/legacyRef<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>
</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_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://fasb.org/us-gaap/role/ref/legacyRef<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>
</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_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://fasb.org/us-gaap/role/ref/legacyRef<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 2: http://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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>
</tr>
<tr>
<td style="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_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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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 3: http://fasb.org/us-gaap/role/ref/legacyRef<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_InterestPayableCurrent</td>
</tr>
<tr>
<td style="padding-right: 4px;white-space:nowrap;"><strong> Namespace Prefix:</strong></td>
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</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://fasb.org/us-gaap/role/ref/legacyRef<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>
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<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>
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<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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 4: http://fasb.org/us-gaap/role/ref/legacyRef<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_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>
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</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 );">- 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>
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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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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6633750096">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Accounts Payable and Accrued Expenses - Additional Information (Detail)<br> $ in Millions</strong></div></th>
<th class="th" colspan="1">6 Months Ended</th>
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<tr><th class="th">
<div>Jun. 30, 2018 </div>
<div>USD ($)</div>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_us-gaap_PayablesAndAccrualsAbstract', window );"><strong>Payables and Accruals [Abstract]</strong></a></td>
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</tr>
<tr class="ro">
<td class="pl custom" style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_IncreaseDecreaseInAccruedPayrollTaxesAndBenefits', window );">Net decrease in accrued salaries and bonuses</a></td>
<td class="nump">$ 80.5<span></span>
</td>
</tr>
</table>
<div style="display: none;">
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_md_IncreaseDecreaseInAccruedPayrollTaxesAndBenefits">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></td></tr>
<tr><td><div class="body" style="padding: 2px;">
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">- Definition</a><div><p>Increase decrease in accrued payroll taxes 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_IncreaseDecreaseInAccruedPayrollTaxesAndBenefits</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_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>
</div>
</body>
</html>
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>42
<FILENAME>R32.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;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6754962944">
<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="2">3 Months Ended</th>
<th class="th" colspan="2">6 Months Ended</th>
</tr>
<tr>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 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>
</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">92,987<span></span>
</td>
<td class="nump">92,181<span></span>
</td>
<td class="nump">92,922<span></span>
</td>
<td class="nump">92,270<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="nump">542<span></span>
</td>
<td class="nump">631<span></span>
</td>
<td class="nump">594<span></span>
</td>
<td class="nump">707<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">93,529<span></span>
</td>
<td class="nump">92,812<span></span>
</td>
<td class="nump">93,516<span></span>
</td>
<td class="nump">92,977<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="nump">392<span></span>
</td>
<td class="nump">8<span></span>
</td>
<td class="nump">197<span></span>
</td>
<td class="nump">5<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://fasb.org/us-gaap/role/ref/legacyRef<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>
</tr>
<tr>
<td style="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>
<tr>
<td style="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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109260490&amp;loc=d3e1500-109256<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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>
<a href="javascript:void(0);" onclick="top.Show.toggleNext( this );">+ Details</a><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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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=109260490&amp;loc=d3e1505-109256<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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109260490&amp;loc=d3e1448-109256<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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_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>
</table>
</div>
</body>
</html>
</TEXT>
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<DOCUMENT>
<TYPE>XML
<SEQUENCE>43
<FILENAME>R33.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;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6766104272">
<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> $ in Millions</strong></div></th>
<th class="th" colspan="2">3 Months Ended</th>
<th class="th" colspan="2">6 Months Ended</th>
<th class="th" colspan="1"></th>
</tr>
<tr>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<th class="th"><div>Jun. 30, 2018</div></th>
<th class="th"><div>Jun. 30, 2017</div></th>
<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_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>
<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="text">&#160;<span></span>
</td>
<td class="nump">200,000,000<span></span>
</td>
<td class="text">&#160;<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_AllocatedShareBasedCompensationExpense', window );">Stock-based compensation expense</a></td>
<td class="nump">$ 10.5<span></span>
</td>
<td class="nump">$ 7.3<span></span>
</td>
<td class="nump">$ 20.4<span></span>
</td>
<td class="nump">$ 14.8<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]</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>
</tr>
<tr class="re">
<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>
<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1', window );">Award vesting period</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</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_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>
<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>
<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_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod', window );">Vesting period of options, maximum years</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</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>
<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>
<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1', window );">Award vesting period</a></td>
<td class="text">&#160;<span></span>
</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_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>
<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>
<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="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</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>
<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>
<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="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</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>
<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>
<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant', window );">Shares available for future grants and awards under Stock Incentive Plans</a></td>
<td class="nump">2,300,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">2,300,000<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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod', window );">Restricted stock granted</a></td>
<td class="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">597,550<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>
<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>
<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="text">&#160;<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">182,888<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="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">1,800,000<span></span>
</td>
<td class="text">&#160;<span></span>
</td>
<td class="nump">1,800,000<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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109197908&amp;loc=d3e5047-113901<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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=115993241&amp;loc=d3e301413-122809<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<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=109197908&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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109197908&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>
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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>
</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_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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 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://fasb.org/us-gaap/role/ref/legacyRef<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=109197908&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>
</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:sharesItemType</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>
<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_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>
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<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://fasb.org/us-gaap/role/ref/legacyRef<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=109197908&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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109197908&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://fasb.org/us-gaap/role/ref/legacyRef<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=109259400&amp;loc=d3e21463-112644<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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_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>
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<td><strong> Data Type:</strong></td>
<td>na</td>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_srt_RangeAxis=srt_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;">srt_RangeAxis=srt_MaximumMember</td>
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<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>
<td>na</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_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>
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<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>
</tr>
</table></div>
</div></td></tr>
</table>
<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PlanNameAxis=md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_PlanNameAxis=md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanMember</td>
</tr>
<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>
<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_PlanNameAxis=md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_PlanNameAxis=md_TwoThousandFifteenNonQualifiedStockPurchasePlanMember</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>
</tr>
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<table border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PlanNameAxis=md_AmendedAndRestatedTwoThousandEightPlanMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_PlanNameAxis=md_AmendedAndRestatedTwoThousandEightPlanMember</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 border="0" cellpadding="0" cellspacing="0" class="authRefData" style="display: none;" id="defref_us-gaap_PlanNameAxis=md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember">
<tr><td class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.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_PlanNameAxis=md_NineteenNinetySixNonQualifiedEmployeeStockPurchasePlanAndTwoThousandFifteenNonQualifiedStockPurchasePlanMember</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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<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>
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<span style="display: none;">v3.10.0.1</span><table class="report" border="0" cellspacing="2" id="idp6754934624">
<tr>
<th class="tl" colspan="1" rowspan="2"><div style="width: 200px;"><strong>Common Stock Repurchase Program - Additional Information (Detail)<br> $ in Millions</strong></div></th>
<th class="th" colspan="1">6 Months Ended</th>
</tr>
<tr><th class="th">
<div>Jun. 30, 2018 </div>
<div>USD ($) </div>
<div>shares</div>
</th></tr>
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<td class="pl " style="border-bottom: 0px;" valign="top"><a class="a" href="javascript:void(0);" onclick="top.Show.showAR( this, 'defref_md_CommonStockLineItems', window );"><strong>Common Stock [Line Items]</strong></a></td>
<td class="text">&#160;<span></span>
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</tr>
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<td class="nump">$ 52.2<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_StatementEquityComponentsAxis=us-gaap_CommonStockMember', window );">Common Stock [Member]</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_md_CommonStockLineItems', window );"><strong>Common Stock [Line Items]</strong></a></td>
<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_StockRepurchasedDuringPeriodShares', window );">Repurchased common stock, shares | shares</a></td>
<td class="nump">1,200,000<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_AwardTypeAxis=us-gaap_RestrictedStockMember', window );">Restricted Stock [Member]</a></td>
<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_md_CommonStockLineItems', window );"><strong>Common Stock [Line Items]</strong></a></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_SharesPaidForTaxWithholdingForShareBasedCompensation', window );">Number of shares withheld to satisfy minimum statutory tax withholding obligations | shares</a></td>
<td class="nump">54,909<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_AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation', window );">Amount withheld to satisfy minimum statutory tax withholding obligations | $</a></td>
<td class="nump">$ 2.5<span></span>
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<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>
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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 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>
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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 class="hide"><a style="color: white;" href="javascript:void(0);" onclick="top.Show.hideAR();">X</a></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_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://fasb.org/us-gaap/role/ref/legacyRef<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=109259400&amp;loc=d3e21463-112644<br><br>Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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 4: http://fasb.org/us-gaap/role/ref/legacyRef<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_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://fasb.org/us-gaap/role/ref/legacyRef<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://fasb.org/us-gaap/role/ref/legacyRef<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=109259400&amp;loc=d3e21463-112644<br><br>Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef<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 4: http://fasb.org/us-gaap/role/ref/legacyRef<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_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>
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<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>
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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_StatementEquityComponentsAxis=us-gaap_CommonStockMember</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>
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end
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>46
<FILENAME>Show.js
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
/**
 * Rivet Software Inc.
 *
 * @copyright Copyright (c) 2006-2011 Rivet Software, Inc. All rights reserved.
 * Version 2.4.0.3
 *
 */

var Show = {};
Show.LastAR = null,

Show.hideAR = function(){
	Show.LastAR.style.display = 'none';
};

Show.showAR = function ( link, id, win ){
	if( Show.LastAR ){
		Show.hideAR();
	}

	var ref = link;
	do {
		ref = ref.nextSibling;
	} while (ref && ref.nodeName != 'TABLE');

	if (!ref || ref.nodeName != 'TABLE') {
		var tmp = win ?
			win.document.getElementById(id) :
			document.getElementById(id);

		if( tmp ){
			ref = tmp.cloneNode(true);
			ref.id = '';
			link.parentNode.appendChild(ref);
		}
	}

	if( ref ){
		ref.style.display = 'block';
		Show.LastAR = ref;
	}
};

Show.toggleNext = function( link ){
	var ref = link;

	do{
		ref = ref.nextSibling;
	}while( ref.nodeName != 'DIV' );

	if( ref.style &&
		ref.style.display &&
		ref.style.display == 'none' ){
		ref.style.display = 'block';

		if( link.textContent ){
			link.textContent = link.textContent.replace( '+', '-' );
		}else{
			link.innerText = link.innerText.replace( '+', '-' );
		}
	}else{
		ref.style.display = 'none';

		if( link.textContent ){
			link.textContent = link.textContent.replace( '-', '+' );
		}else{
			link.innerText = link.innerText.replace( '-', '+' );
		}
	}
};
</TEXT>
</DOCUMENT>
<DOCUMENT>
<TYPE>XML
<SEQUENCE>47
<FILENAME>report.css
<DESCRIPTION>IDEA: XBRL DOCUMENT
<TEXT>
/* Updated 2009-11-04 */
/* v2.2.0.24 */

/* DefRef Styles */
..report table.authRefData{
	background-color: #def;
	border: 2px solid #2F4497;
	font-size: 1em;
	position: absolute;
}

..report table.authRefData a {
	display: block;
	font-weight: bold;
}

..report table.authRefData p {
	margin-top: 0px;
}

..report table.authRefData .hide {
	background-color: #2F4497;
	padding: 1px 3px 0px 0px;
	text-align: right;
}

..report table.authRefData .hide a:hover {
	background-color: #2F4497;
}

..report table.authRefData .body {
	height: 150px;
	overflow: auto;
	width: 400px;
}

..report table.authRefData table{
	font-size: 1em;
}

/* Report Styles */
..pl a, .pl a:visited {
	color: black;
	text-decoration: none;
}

/* table */
..report {
	background-color: white;
	border: 2px solid #acf;
	clear: both;
	color: black;
	font: normal 8pt Helvetica, Arial, san-serif;
	margin-bottom: 2em;
}

..report hr {
	border: 1px solid #acf;
}

/* Top labels */
..report th {
	background-color: #acf;
	color: black;
	font-weight: bold;
	text-align: center;
}

..report th.void	{
	background-color: transparent;
	color: #000000;
	font: bold 10pt Helvetica, Arial, san-serif;
	text-align: left;
}

..report .pl {
	text-align: left;
	vertical-align: top;
	white-space: normal;
	width: 200px;
	white-space: normal; /* word-wrap: break-word; */
}

..report td.pl a.a {
	cursor: pointer;
	display: block;
	width: 200px;
	overflow: hidden;
}

..report td.pl div.a {
	width: 200px;
}

..report td.pl a:hover {
	background-color: #ffc;
}

/* Header rows... */
..report tr.rh {
	background-color: #acf;
	color: black;
	font-weight: bold;
}

/* Calendars... */
..report .rc {
	background-color: #f0f0f0;
}

/* Even rows... */
..report .re, .report .reu {
	background-color: #def;
}

..report .reu td {
	border-bottom: 1px solid black;
}

/* Odd rows... */
..report .ro, .report .rou {
	background-color: white;
}

..report .rou td {
	border-bottom: 1px solid black;
}

..report .rou table td, .report .reu table td {
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end
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
